摘要
目的分析恶性肿瘤并肺栓塞(PE)患者CT平扫、CT肺动脉造影(CTPA)影像特点及临床特征。方法回顾性选取本院2021年4月至2023年12月期间收治的140例恶性肿瘤患者为研究对象,依据患者是否伴发PE将其分为PE组(n=62)及非PE组(n=78),比较两组患者CT平扫、CTPA影像特点差异,并收集患者资料采用单因素及多因素Logistic回归分析恶性肿瘤并PE患者临床特征。结果PE组肺内渗出病变、胸腔积液所占比例分别为77.78%、61.11%,较非PE组54.55%、36.36%均显著高(P<0.05);两组肺动脉高压、肺动脉增宽、右心室增大、肺动脉直径、RV/LV、栓塞指数及栓子密度对比,差异无统计学差异(P>0.05);62例恶性肿瘤并PE患者中,中央型栓塞50例(80.65%),周围性栓塞12例(19.35%)。多因素Logistic回归分析结果显示D-二聚体(OR=2.385,95%CI=1.259~4.518)、血小板计数(OR=2.776,95%CI=1.197~6.436)以及Khorana评分(OR=2.620,95%CI=1.380~4.972)为恶性肿瘤并发PE的危险因素(P<0.05)。结论恶性肿瘤并PE具有明显的影像学特点及临床特征,当CTPA提示肺内渗出病变、胸腔积液且D-二聚体、血小板计数以及Khorana评分升高时,应警惕PE的发生,提高相关认识有助于进一步诊断及治疗。
Objective To analyze plain CT scan and CT pulmonary angiography(CTPA)imaging characteristics and clinical characteristics of patients with malignant tumors and pulmonary embolism(PE).Methods A retrospective study was conducted.140 patients with malignant tumors who were admitted to the hospital from April 2021 to December 2023 were enrolled in this study.They were divided into PE group(n=62)and non-PE group(n=78)according to the presence or absence of PE.Plain CT scan and CTPA imaging characteristics of the two groups were comparatively analyzed.Univariate analysis and multivariate Logistic regression analysis were conducted to screen the risk factors for PE in patients with malignant tumors.Results The proportions of patients with pulmonary effusion and pleural effusion in the PE group(77.78%and 61.11%)were significantly higher than those in the non-PE group(54.55%and 36.36%)(P<0.05).There was no statistically significant difference between the two groups in terms of pulmonary hypertension,pulmonary artery widening,right ventricular enlargement,pulmonary artery diameter,RV/LV,embolism index,and thrombus density(P>0.05).Among 62 patients with malignant tumors and PE,there were 50(80.65%)cases of central embolism and 12(19.35%)cases of peripheral embolism.The results of multivariate Logistic regression analysis showed that D-dimer(OR=2.385,95%CI=1.259-4.518),platelet count(OR=2.776,95%CI=1.197-6.436),and Khorana score(OR=2.620,95%CI=1.380-4.972)were risk factors for malignant tumors complicated with PE(P<0.05).Conclusion Patients with malignant tumors with PE have obvious imaging and clinical characteristics.When CTPA indicates pulmonary effusion,pleural effusion,and elevated D-dimer,platelet count and Khorana score,attention should be paid to the occurrence of PE.Increasing relevant knowledge is conducive to further diagnosis and treatment.
作者
温莎
夏傲
肖战丽
Wen Sha;Xia Ao;Xiao Zhan-li(Intensive Care Unit,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450003,Henan Province,China;CT Room,Department of Mdeical Imaging,Zhoukou Central Hospital,Zhoukou 466000,HenanProvince,China)
出处
《中国CT和MRI杂志》
2024年第11期53-55,共3页
Chinese Journal of CT and MRI
基金
2023年河南省周口市科技发展项目(126)。
关键词
恶性肿瘤
肺栓塞
CT肺动脉造影
影像特点
临床特征
Malignant Tumor
Pulmonary Embolism
CT Pulmonary Angiography
Image Characteristic
Clinical Characteristic
