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CT 血管造影肺动脉阻塞指数与急性肺血栓栓塞症患者临床资料的相关性。

The correlation between the CT angiographic pulmonary artery obstructive index and clinical data in patients with acute pulmonary thromboembolism.

机构信息

Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Radiology Department, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Emerg Radiol. 2024 Feb;31(1):45-51. doi: 10.1007/s10140-023-02187-w. Epub 2023 Dec 15.

Abstract

PURPOSE

The potentially fatal consequences of pulmonary embolism emphasize the need for more effective diagnostic methods. The Qanadli obstruction index has been described as a convenient tool for risk stratification to determine and quantify the degree of obstruction. This study aimed to assess the correlations between the Qanadli index with clinical and paraclinical findings (D-dimer, troponin, and echocardiographic findings) in patients with pulmonary embolism.

MATERIALS AND METHODS

A total of 102 patients with pulmonary embolism underwent echocardiography and CT pulmonary angiography at a single tertiary referral center between 2019 and 2020. The clinical and paraclinical findings, pulmonary arterial obstruction index, atrial measurements, right and left ventricle size and function, tricuspid annular plane systolic excursion, pulmonary artery pressure, and pulmonary hypertension (PH) were analyzed. Vital signs were recorded and assessed. The Qanadli index score was measured, and graded risk stratification was measured based on the quantified index score.

RESULTS

The total mean Qanadli index was 28.75 ± 23.75, and there was no significant relationship between the Qanadli index and gender. Patients' most common clinical findings were exertional dyspnea (84.3%; n = 86) and chest pain (71.7%; n = 73). There were significant correlations between the Qanadli index and pulse rate (PR), troponin, D-dimer levels, and PH. Four patients died during the study, including one from a cardiac condition and three with non-cardiac conditions.

CONCLUSIONS

It is possible to determine the severity, prognosis, and appropriate treatment by the Qanadli index based on strong correlations with PR, troponin, D-dimer levels, and PH.

摘要

目的

肺栓塞可能致命的后果强调了需要更有效的诊断方法。Qanadli 阻塞指数已被描述为一种用于风险分层的便捷工具,用于确定和量化阻塞程度。本研究旨在评估 Qanadli 指数与肺栓塞患者的临床和辅助检查结果(D-二聚体、肌钙蛋白和超声心动图结果)之间的相关性。

材料和方法

2019 年至 2020 年期间,在一家三级转诊中心对 102 例肺栓塞患者进行了超声心动图和 CT 肺动脉造影检查。分析了临床和辅助检查结果、肺动脉阻塞指数、心房测量值、右心室和左心室大小和功能、三尖瓣环平面收缩期位移、肺动脉压和肺动脉高压(PH)。记录并评估生命体征。测量 Qanadli 指数评分,并根据量化的指数评分进行分级风险分层。

结果

总平均 Qanadli 指数为 28.75±23.75,Qanadli 指数与性别之间无显著关系。患者最常见的临床发现是运动性呼吸困难(84.3%,n=86)和胸痛(71.7%,n=73)。Qanadli 指数与脉搏率(PR)、肌钙蛋白、D-二聚体水平和 PH 之间存在显著相关性。研究期间有 4 例患者死亡,其中 1 例死于心脏疾病,3 例死于非心脏疾病。

结论

根据与 PR、肌钙蛋白、D-二聚体水平和 PH 的强相关性,可以通过 Qanadli 指数确定严重程度、预后和适当的治疗。

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