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CTPA 肺动脉可扩张性评估急性肺栓塞严重程度和右心室功能。

CTPA pulmonary artery distensibility in assessment of severity of acute pulmonary embolism and right ventricular function.

机构信息

Department of Cardiothoracic Surgery.

Department of Medical Imaging, The First Affiliated Hospital of Hebei North University, Zhangjiakou.

出版信息

Medicine (Baltimore). 2021 Jan 22;100(3):e24356. doi: 10.1097/MD.0000000000024356.

Abstract

To investigate the characteristics of pulmonary artery distensibility (PAD) in patients with acute pulmonary embolism (APE) and to assess the correlation of PAD with APE severity and right ventricular function. A total of 33 patients who underwent retrospective electrocardiogram (ECG)-gated computed tomography pulmonary angiography (CTPA) with a definite diagnosis of APE were included in the study. According to APE severity, the patients were divided into severe (SPE) and non-severe (NSPE) groups. Data from a control group without APE matching the basic demographics of the APE patients were collected. Pulmonary artery distensibility (PAD) and right ventricular function parameters were compared among the 3 groups, their relationships were investigated, and receiver operating characteristic (ROC) curves were used to determine the sensitivity and specificity of the above parameters for the diagnosis of APE severity. The PAD values of the control, NSPE, and SPE groups were (7.877 ± 2.637) × 10-3 mm/Hg, (6.050 ± 2.011) × 10-3 mm/Hg, (4.321 ± 1.717) × 10-3 mm/Hg, respectively (P < .01). There were statistically significant differences in right ventricular function parameters among the 3 groups (P < .05). The correlation analysis between PAD and right ventricular function parameters showed a weak negative correlation (r = -0.281--0.392). The area under the ROC curve of PAD was 0.743, the critical value was 4.200, and the sensitivity and specificity were 62.5% and 94.1%, respectively. The PAD obtained by retrospective ECG-gated CTPA could accurately evaluate APE severity and right ventricular function. As the severity of APE increases, PAD decreases, which is helpful to identify patients at high risk of APE.

摘要

目的

探讨急性肺栓塞(APE)患者肺动脉可扩张性(PAD)的特点,并评估 PAD 与 APE 严重程度和右心室功能的相关性。

方法

本研究共纳入 33 例经回顾性心电图(ECG)门控计算机断层扫描肺动脉造影(CTPA)明确诊断为 APE 的患者。根据 APE 严重程度,将患者分为严重组(SPE)和非严重组(NSPE)。收集与 APE 患者基本人口统计学特征相匹配的无 APE 对照组的数据。比较 3 组患者的 PAD 和右心室功能参数,探讨其相关性,并采用受试者工作特征(ROC)曲线确定上述参数诊断 APE 严重程度的敏感性和特异性。

结果

对照组、NSPE 组和 SPE 组的 PAD 值分别为(7.877±2.637)×10-3 mm/Hg、(6.050±2.011)×10-3 mm/Hg和(4.321±1.717)×10-3 mm/Hg(P<0.01)。3 组患者的右心室功能参数存在统计学差异(P<0.05)。PAD 与右心室功能参数的相关性分析显示,两者呈弱负相关(r=-0.281--0.392)。PAD 的 ROC 曲线下面积为 0.743,临界值为 4.200,敏感性和特异性分别为 62.5%和 94.1%。

结论

回顾性 ECG 门控 CTPA 获得的 PAD 能准确评估 APE 严重程度和右心室功能,随着 APE 严重程度的增加,PAD 降低,有助于识别高危 APE 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80ab/7837935/ceebc93eed80/medi-100-e24356-g001.jpg

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