| 蒲艳军,何芬,李文玲,田兴仓,屈先凤,朱力.双源CT灌注缺损评分评价急性肺栓塞严重程度的临床应用[J].中国医学影像技术,2015,31(10):1540~1544 |
| 双源CT灌注缺损评分评价急性肺栓塞严重程度的临床应用 |
| Application of dual-source CT perfusion defect score in assessment of acute pulmonary embolism severity |
| 投稿时间：2015-01-20 修订日期：2015-03-06 |
| DOI：10.13929/j.1003-3289.2015.10.022 |
| 中文关键词: 肺栓塞 体层摄影术,X线计算机 灌注成像 |
| 英文关键词:Pulmonary embolism Tomography, X-ray computed Perfusion imaging |
| 基金项目:宁夏回族自治区科技攻关项目。 |
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| 中文摘要: |
| 目的 探讨应用双源CT灌注缺损评分(P-score)评价急性肺栓塞(APE)严重程度的临床应用价值。方法 回顾性分析57例APE患者的临床及影像学检查资料。依据右心室与左心室直径比值(RVd/LVd)分为RVd/LVd ≥1组与RVd/LVd< 1组,比较两组P-score、CT肺动脉阻塞评分(CTPAOI)、心脏、血管形态学测量指标、右心室压力CT征象的差异。并分析APE患者P-score与CTPAOI、RVd/LVd及动脉血气分析指标的相关性。结果 两组间P-score、CTPAOI、主肺动脉直径(mPAd)、上腔静脉直径(SVCd)及奇静脉直径(AVd)差异均有统计学意义(P均<0.05);室间隔凸向左心室腔或平直、下腔静脉及奇静脉对比剂反流差异均有统计学意义(P均<0.05)。APE患者P-score与CTPAOI呈正相关(r=0.75,P<0.001),与RVd/LVd呈正相关(r=0.54,P<0.001);与氧分压(PaO2)、二氧化碳分压(PaCO2)及血氧饱和度(SaO2)均呈负相关(r=－0.31、－0.29、－0.27,P均<0.05)。结论 P-score与CTPAOI、RVd/LVd及动脉血气分析指标明显相关,P-score结合CTPAOI、心脏、血管形态学测量及动脉血气分析可较准确地评价APE的严重程度。 |
| 英文摘要: |
| Objective To assess the application value of dual-source CT perfusion defect score (P-score) in evaluating the severity of acute pulmonary embolism (APE). Methods A retrospective analysis of 57 patients with APE was performed. All the patients were divided into 2 groups according to the ratio of right ventricle diameter to left ventricle diameter (RVd/LVd), including RVd/LVd≥1 group and RVd/LVd<1 group. The P-score, CT pulmonary angiography obstruction index (CTPAOI), cardiovascular morphological measurement parameters, CT features related to right heart pressure were compared between groups. And the correlations between P-score, CTPAOI, RVd/LVd and the indexes of arterial blood gas were studied. Results Statistical differences of P-score, CTPAOI, main pulmonary artery diameter (mPAd), superior vena cava diameter (SVCd) and azygos vein diameter (AVd) were found between the 2 groups (all P<0.05). And there were statistical differences of interventricular septum convex or flat to the left ventricular, contrast medium reflux into inferior vena cava and contrast medium reflux into azygos vein (all P<0.05). The P-score positively correlated to CTPAOI (r=0.75, P<0.001) and RVd/LVd (r=0.54, P<0.001), while negatively correlated to the indexes of arterial blood gas (PaO2, PaCO2 and SaO2, r=－0.31, －0.29, －0.27, all P<0.05). Conclusion P-score has obvious correlation with CTPAOI, RVd/LVd and blood gas parameters. P-score combined with CTPAOI, morphological measurement and blood gas parameters is helpful to improve the accuracy of APE severity assessment. |
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