急性肺栓塞患者的右心室功能：心电图同步多排螺旋CT分析
Right ventricular function in patients with acute pulmonary embolism: analysis with electrocardiography-synchronized multi-detector row CT.
作者信息
Doğan Halil, Kroft Lucia J M, Huisman Menno V, van der Geest Rob J, de Roos Albert
机构信息
Department of Radiology, Leiden University Medical Center, Albinusdreef 2, C2-S, 2333 ZA Leiden, the Netherlands.
出版信息
Radiology. 2007 Jan;242(1):78-84. doi: 10.1148/radiol.2421052089. Epub 2006 Nov 7.
PURPOSE
To prospectively assess electrocardiography (ECG)-synchronized multi-detector row computed tomography (CT) for the evaluation of right ventricular (RV) function in patients suspected of having pulmonary embolism (PE).
MATERIALS AND METHODS
All patients gave informed consent after the study details, including radiation exposure, were explained; institutional ethical committee approval was obtained. Nonsynchronized multi-detector row CT of the chest was performed in 66 consecutive patients (29 men, 37 women; mean age, 58 years+/-15 [standard deviation]) who were suspected of having PE. ECG-synchronized cardiac multi-detector row CT was performed to assess cardiac function. Dimension ratios for the RV and left ventricle (LV) were measured on nonsynchronized transverse and angulated four-chamber views. Furthermore, the RV end-diastolic and end-systolic volumes were measured on ECG-synchronized multi-detector row CT scans. An independent samples t test was performed to compare the mean value of different groups. An analysis of variance post hoc test was performed to investigate whether the values of the variables varied between groups.
RESULTS
PE was detected in 29 of 66 patients. The location of PE was categorized as central (n=17) or peripheral (n=12). The RV/LV dimension ratio was larger on the four-chamber view (P=.002), and RV end-systolic volume was larger (P=.01) and ejection fraction was lower (P=.01) in patients with PE. The RV end-systolic volumes and RV/LV volume ratios, as assessed by using ECG-synchronized multi-detector row CT, showed significant differences (P<.005) between patients with central PE and those with peripheral PE. However, the RV/LV dimensions on nonsynchronized images revealed no significant differences.
CONCLUSION
Retrospective ECG-synchronized multi-detector row CT facilitates detection of RV dysfunction, depending on pulmonary embolus location.
目的
前瞻性评估心电图（ECG）同步的多排探测器计算机断层扫描（CT）在疑似肺栓塞（PE）患者右心室（RV）功能评估中的应用。
材料与方法
在向所有患者详细解释研究细节（包括辐射暴露）后，患者均签署知情同意书；研究获得了机构伦理委员会的批准。对66例连续的疑似PE患者（29例男性，37例女性；平均年龄58岁±15[标准差]）进行了胸部非同步多排探测器CT检查。进行ECG同步心脏多排探测器CT以评估心脏功能。在非同步的横轴位和成角四腔视图上测量RV和左心室（LV）的维度比值。此外，在ECG同步多排探测器CT扫描上测量RV舒张末期和收缩末期容积。进行独立样本t检验以比较不同组的平均值。进行方差分析事后检验以研究变量值在组间是否存在差异。
结果
66例患者中有29例检测到PE。PE的位置分为中央型（n = 17）或周围型（n = 12）。在四腔视图上，PE患者的RV/LV维度比值更大（P = 0.002），RV收缩末期容积更大（P = 0.01），射血分数更低（P = 0.01）。使用ECG同步多排探测器CT评估的RV收缩末期容积和RV/LV容积比值在中央型PE患者和周围型PE患者之间显示出显著差异（P < 0.005）。然而，非同步图像上的RV/LV维度无显著差异。
结论
回顾性ECG同步多排探测器CT有助于根据肺栓塞位置检测RV功能障碍。
Zotero 插件