急性肺动脉栓塞的CT表现在疾病危险分级中的价值

摘要

目的:回顾性分析急性肺动脉栓塞(APE)的CT肺动脉血管成像(CTPA)表现与疾病危险程度相关因素,并探讨CTPA在评价急性肺动脉栓塞危险分级中的价值.方法:根据2014ESC的sPESI标准将28例经CTPA确诊的急性肺动脉栓塞患者分为危重组和非危重组,分别测量两组病例右心室最大层面短轴(RVd)和左心室最大层面短轴(LVd),并计算其比值(RVd/ LVd);记录每个病例肺动脉的栓塞数量和栓塞程度,计算Qanadli评分,并对右心室/左心室的最大层面短轴比值(RVa/ LVd)和Qanadli评分进行分析.结果:危重组的右心室/左心室的最大层面短轴比值和Qanadli评分明显大于非危重组.右心室/左心室的最大层面短轴比值和Qanadli评分之间显著正相关(r=0.804,P＜0.01),且存在线性关系(β=59.144,P＜0.01);危重和非危重患者的Qanadli评分和RVd/LVd均呈现显著性差异.结论:CTPA对评价急性肺动脉栓塞的危险分级具有重要的价值.%Objective:To retrospectively analyze the correlation between the manifestations of CT pulmonary angiography (CTPA) and disease risk factors,and to explore the value of CTPA in acute pulmonary embolism (APE) risk classification.Methods:According to sPESI standard of 2014ESC,28 APE patients (proved by CTPA) were divided into critical group and non-critical group.The right ventricular maximum minor axis (RVd) and the left ventricular maximum minor axis (LVd) of each patient were measured,and then the ratio of RVd/LVdwas calculated.The number of pulmonary artery embolism and the degree of vascular obstruction were recorded,then Qanadli score was calculated.Finally the correlation between RVd/LVd ratio and Qanadli score was analyzed.Results:The correlation of RVd/ LVd ratio and Qanadli score in the critical group was significantly greater than that in the non-critical group.There were significant positive correlation (r =0.804,P ＜0.01) and linear relationship (β =59.144,P ＜0.01) between RVd/LVd ratio and Qanadli score.For both critical and non-critical groups,there were significant differences between Qanadli score and RVd/LVd.Conclusion:CTPA has an important value to evaluate the risk of APE.