恶性肿瘤合并肺栓塞的CT肺动脉造影及临床表现分析

摘要

目的 探讨恶性肿瘤合并肺栓塞的CT肺动脉造影(CT pulmonary angiography,CTPA)和临床表现.方法 收集88例经CTPA诊断的肺栓塞病例,按是否伴有恶性肿瘤分成恶性肿瘤组(28例)和非肿瘤组(60例),分别测量肺动脉直径,左右心室的最大短轴直径及其比值,血栓密度,计算栓塞指数,记录栓塞部位、胸腔积液和肺内渗出性病变的发生情况.对恶性肿瘤组,按肿瘤部位分类统计,并对肺栓塞(PE)发生时间和临床表现作记录.结果 本组资料中央性肺栓塞恶性肿瘤组有22例(78%),非肿瘤组有34例(57%),P<0.05,显示恶性肿瘤合并肺栓塞者栓塞容易发生于中央性肺动脉;出现胸腔积液和肺内渗出性病变的几率恶性肿瘤组亦高于非肿瘤组;血栓密度、栓塞指数以及反映右心功能的指标2组无统计学差异.合并肺栓塞的恶性肿瘤以腺癌最多见,特别是进展期已发生转移的恶性肿瘤.结论 恶性肿瘤伴肺栓塞具有一些影像和临床特征,提高相关认识有助于临床诊断和进一步治疗.%Objective To explore the imaging and clinical characteristics of pulmonary embolism) PE) complicated in malignant tumors. Methods 88 patients with PE confirmed by CT pulmonary angiography (CTPA) included cancer group (n =28) and non-cancer group(n-60). The pulmonary arterial (PA) diameter, right and left ventricular diameter,thrombus density and location, obstruction index, occurrence of plcural effusion and lung exudative lesions were retrospectively analyzed. The clinical manifestations and the presented time of PE were recorded. Results The central PE presented in 28 cases (78%) in cancer group and 34 cases (57 % ) in non-cancer group, there was statistical difference between thcm( P＜0. 05). Which showed that the patients with malignant tumors had higher risk to developc central Pes, and the incidence of plcural effusion and lung exudative lesions was higher in tumor group than non-tumor group. There was no statistically different in thrombus density, embolism index and right ventricular function indicators between both tumor and non-tumor group. PE in patients with adenocarcinoma was more developed, especially the advanced cancer with metastasis. Conclusion Awareness of the imaging and clinical features of PE complicated in malignant tumors arc beneficial to clinical diagnosis and further treatment.