MSCT对COPD相关性肺动脉高压的诊断价值

发布时间：2018-03-14 00:29

本文选题：慢性阻塞性肺疾病　切入点：肺动脉主干　出处：《山西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：研究目的：探究主肺动脉直径(MPA)、主肺动脉直径/升主动脉直径(rPAA)、主肺动脉直径/降主动脉直径(rPDA)、右下肺动脉直径(RIPA)及段动脉/伴行支气管直径(dA/B)对慢性阻塞性肺疾病(COPD)相关性肺动脉高压(PH)的诊断价值。资料与方法：收集经临床确诊为COPD、且怀疑伴有肺动脉高压的患者60例,并全部行超声心动图(UCG)及MSCT胸部平扫检查。在MSCT扫描预定层面上测量并计算MPA、rPAA、rPDA、RIPA及dA/B。以MPA29mm、rPAA1、rPDA1、 RIPA15mm、或者至少3/4个肺叶的dA/B1作为MSCT诊断肺动脉高压的依据,并同时观察肺实质及右心的变化情况。将肺动脉收缩压(PASP)分别与MPA、 rPAA、rPDA、RIPA及4个段dA/B进行相关性分析,对MSCT图像所测上述指标与UCG诊断PH进行一致性检验,分析在MSCT图像上用哪一个指标诊断PH与UCG诊断PH的一致性较好。结果： MPA、rPAA与肺动脉收缩压呈明显相关性(r=0.699,P0.05和r=0.510,P0.05),其它指标(rPDA、RIPA、4个段dA/B)与肺动脉收缩压没有明显相关性。以MPA或rPAA这两个指标诊断PH,与超声心动图诊断PH具有很好的一致性(Kappa0.7),差异无统计学意义(P0.05)。结论： 1.MSCT是诊断COPD相关性肺动脉高压的好的影像学方法,具有很高的临床实用价值。 2."MPA29mm"和"rPAA1"是诊断COPD相关性肺动脉高压的可靠指标。 3.rPDA、RIPA和dA/B与PASP无明显相关性。
[Abstract]:Objectives of the study:. To investigate the effects of main pulmonary artery diameter (MPAA), aorta diameter / ascending aorta diameter (RPAA), aorta diameter / descending aorta diameter (RPDAA), right inferior pulmonary artery diameter (RIPAA) and segmental artery / accompanied bronchi diameter (na / B) on chronic obstructive pulmonary disease (COPD). The diagnostic value of pulmonary hypertension (PHH). Information and methods:. A total of 60 patients with suspected pulmonary hypertension, who were clinically diagnosed as COPDs, were collected. All patients were examined by echocardiography (UCG) and MSCT chest plain scan. RIPA and da / B were measured and calculated on the predefined plane of MSCT scan. DA/B1 of MPA29mm rPAA1rPDA1, RIPA15mm, or at least 3/4 lobes of lung were used as the basis for the diagnosis of pulmonary hypertension. At the same time, the changes of pulmonary parenchyma and right heart were observed. The pulmonary artery systolic pressure (PASP) was correlated with MPA, rPAA, rPDARIPA and four segments of dA/B, respectively, and the consistency between the above indexes measured on MSCT images and the diagnosis of PH in UCG was checked. To analyze which index to diagnose PH on MSCT image is consistent with that of UCG. Results:. MPA-rPAA was significantly correlated with pulmonary arterial systolic blood pressure (PAP) (P 0.05) and RPA (0. 510) P 0. 05 (P < 0 05). There was no significant correlation between pulmonary arterial systolic blood pressure (PAP) and pulmonary arterial systolic blood pressure (PAP). The diagnosis of pulmonary artery systolic blood pressure (PAP) by MPA or rPAA was in good agreement with the diagnosis of PH by echocardiography (P < 0. 05) and Kappa 0. 7% (P < 0. 05). The difference was not statistically significant (P 0.05). Conclusion:. 1. MSCT is a good imaging method for the diagnosis of COPD associated pulmonary hypertension. 2. MPA29mm and rPAA1 are reliable markers for the diagnosis of COPD associated pulmonary hypertension. 3. RPDAA RIPA and dA/B had no significant correlation with PASP.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R544.1;R816.41

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