摘要
目的:探讨CT肺动脉成像(CTPA)对急性肺栓塞(APE)肺动脉高压严重程度的诊断价值。方法:根据多普勒超声心动图估算肺动脉收缩压(PASP),将APE患者分为2组:中重度(45例)和轻度肺动脉高压组(29例)。在CTPA上测量心血管径线,包括主肺动脉、左肺动脉、右肺动脉直径、右下肺动脉和升主动直径以及右室和左室短轴最大径。计算主肺动脉直径与升主动脉直径比值(rPA)、右室与左室短轴最大径比值(RV/LV)。使用t检验评价中重度与轻度肺动脉高压组之间心血管参数的差异;使用ROC曲线确定CTPA诊断中重度肺动脉高压的敏感度和特异度,计算和比较ROC曲线下面积(AUC值);使用Pearson等级相关系数评价肺动脉压与心血管测量值之间的相关性。结果:轻度和中重度肺动脉高压组之间差异有统计学意义的指标为主肺动脉直径(P<0.001)、左肺动脉直径(P=0.001)、右肺动脉直径(P=0.001)、右室短轴最大径(P<0.001)、左室短轴最大径(P<0.001)、rPA(P<0.001)、RV/LV(P<0.001)。主肺动脉直径、rPA、RV/LV的AUC值均高于0.8(P<0.01)。PASP与主肺动脉直径(r=0.160)、左肺动脉直径(r=0.258)、右肺动脉直径(r=0.264)、右心室短轴最大径(r=0.401)、左心室短轴最大径(r=-0.511)、rPA(r=0.670)、RV/LV(r=0.644)之间的相关性均有统计学意义,其中rPA与PASP之间的相关系数最高(r=0.670)。结论:CTPA不仅可以诊断PE,并且可以通过rPA、RV:LV等指标评估肺动脉高压严重程度,有助于临床判断预后及治疗方案的选择。
Objective：To determine the value of CT pulmonary angiography （CTPA） in estimating the severity of pul monary hypertension caused by acute pulmonary embolism （APE）. Methods： According to PASP by Doppler echocardio graphy,74 patients were divided into two groups：moderate or severe PH （n=45） and mild PH （n 29）. Cardiovascular pa rameters were measured in CTPA including main pulmonary artery diameter （MPAD）, left pulmonary artery diameter （ LPAI））, right pulmonary artery diameter （RPAD）, ascending aorta diameter （ AAD）, right lower pulmonary artery diameter （RLPAD）, right ventricular （RV） and left ventricular （LV） maximal short axis; and parameters were calculated inclu ding rPA, RV/LV. The results were analyzed by t test, receiver operating characteristic curve,and Pearson＇s rank correlation coefficient. Results：Comparision of cardiovascular parameters between patients with moderate or severe PH and mild PH showed significant differences in MPAD （P〈0. 001）,LPAD （P=0. 001） ,RPAD （P=0. 001）,RV （P〈0. 001）,LV （P〈 0. 001）,rPA （P〈0. 001）,RV/LV （P〈0. 001）. AUC values were significantly higher than 0.8 for MPAD,rPA, RV/LV. The correlation between PASP and cardiovascular parameters was significant. Pearson＇s rank correlation coefficient was highest between rPA and PASP. Conclusion： CTPA can not only diagnose PE, but also estimate the severity of pulmonary hypertension by rPA, RV ： LV, etc, which contributes to the clinical prognosis and treatment options.
出处
《放射学实践》
2013年第3期324-328,共5页
Radiologic Practice
基金
江苏高校优势学科建设工程资助项目(JX10231801)
关键词
体层摄影术
X线计算机
血管成像
肺栓塞
肺动脉高压
肺动脉
Tomography,X-ray computed
Angiography
Pulmonary embolism
Pulmonary hypertension
Pulmonary artery
