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利用CT肺动脉造影探索肺栓塞的多种影像学表现:病例系列及文献综述

Exploring varied radiologic appearance in pulmonary embolism with CT pulmonary angiography: Case series with literature review.

作者信息

Simargi Yopi, Dewi Apriliani Puspa, Charlee Michaela Alexandra, Valerie Natasha, Ronny Ronny, Susilo Fenny

机构信息

Department of Radiology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.

出版信息

Radiol Case Rep. 2024 May 23;19(8):3367-3371. doi: 10.1016/j.radcr.2024.04.081. eCollection 2024 Aug.

Abstract

Pulmonary embolism (PE) is a life-threatening condition caused by a sudden blockage of pulmonary arteries. Nonspecific and extremely variable clinical presentation frequently leads to undetected cases, making computed tomography pulmonary angiography (CTPA) hold a crucial role in the diagnosis of PE. This case series presents numerous types and findings of PE in CTPA among patients with different initial presentations followed by a literature review. We presented 3 cases with different initial presentations such as dyspnea with wheezing, productive cough, and hematemesis. All patients were consequently evaluated for D-dimer due to suspicion of PE from cardiac ultrasonography, electrocardiography (ECG), and persistent symptoms. Large to subsegmental PE can be found with various secondary findings such as pleural effusion and Hampton's hump. All patient's conditions were improved after anticoagulant treatment. This case series highlights the significance of CTPA as an imaging modality in the diagnosis of PE, as well as the necessity of evaluating the main to subsegmental pulmonary artery through an in-depth understanding of the images that can be assessed on CTPA.

摘要

肺栓塞(PE)是一种由肺动脉突然阻塞引起的危及生命的疾病。其临床表现不具特异性且变化极大,常常导致漏诊病例,这使得计算机断层扫描肺动脉造影(CTPA)在PE的诊断中发挥着关键作用。本病例系列展示了不同初始表现患者CTPA中PE的多种类型及表现,随后进行了文献综述。我们呈现了3例初始表现不同的病例,如伴有哮鸣音的呼吸困难、咳痰以及呕血。由于心脏超声、心电图(ECG)检查以及持续症状而怀疑为PE,所有患者均接受了D - 二聚体检测。可发现大至亚段性PE,并伴有各种继发性表现,如胸腔积液和汉普顿驼峰征。所有患者经抗凝治疗后病情均有改善。本病例系列强调了CTPA作为PE诊断成像方式的重要性,以及通过深入理解CTPA上可评估的图像来评估主肺动脉至亚段肺动脉的必要性。

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