[1]朱洪基,余建群,彭礼清.心电门控双源CTPA评价急性肺栓塞及其右心室功能[J].心血管病学进展,2019,(6):955-959.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.029]
　ZHU Hongji,YU Jianqun,PENG Liqing.Evaluation of Acute Pulmonary Embolism and Its Right Ventricular Function by ECG Gated Dual-source CTPA[J].Advances in Cardiovascular Diseases,2019,(6):955-959.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.029]
点击复制

心电门控双源CTPA评价急性肺栓塞及其右心室功能()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2019年6期
页码:
955-959
栏目:
论著
出版日期:
2019-09-25

文章信息/Info

Title:
Evaluation of Acute Pulmonary Embolism and Its Right Ventricular Function by ECG Gated Dual-source CTPA
作者:
朱洪基1; 余建群2; 彭礼清2
(1.中国科学技术大学附属第一医院影像科,安徽 合肥 230000;2.四川大学华西医院放射科,四川 成都 610041 )
Author(s):
ZHU Hongji1;  YU Jianqun2;  PENG Liqing2
(1.Department of Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui, China2. Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
关键词:
心电门控; 双源CT; 肺栓塞; 心功能
Keywords:
ECG-gated; Dual-source CT; Pulmonary embolism; Cardiac function
DOI:
10.16806/j.cnki.issn.1004-3934.2019.06.029
摘要:
目的 探讨心电门控双源CT肺动脉血管成像（CTPA）在评价急性肺栓塞（APE）及其右心室功能的临床价值。方法 54例患者行回顾性心电门控下CTPA检查后，经图像后处理并进行重建，观察肺动脉栓塞的分布、程度并计算肺栓塞指数，分析心功能。根据栓塞位置分为两组，中央型与周围型。比较有无肺栓塞患者右心功能参数组间差异；对比不同栓塞程度及栓塞部位组间心功能参数差异性。结果 肺栓塞组右室舒张末期容积及收缩末期容积均较无栓塞组高，右室射血分数（RVEF）值较无栓塞组减低（P＜0.05），右室每搏量较无栓塞组减低，两组间差异无统计学意义（P＞0.05）。随着栓塞程度加重，RVEF逐渐减低，且三组间RVEF整体差异有统计学意义（P＜0.05）。中央型较周围型、无栓塞组RVEF明显减低，RVEF在三组间差异均有统计学意义（P＜0.05） 结论 CTPA可准确地评价肺栓塞分布、程度及栓塞指数，评价的心功能对临床也具有一定的价值。
Abstract:
Objective To investigate the clinical value of ECG-gated dual-source CTPA in evaluating acute pulmonary embolism and right ventricular function. Methods 54 patients underwent retrospective ECG-assisted CTPA examination, post-image reconstruction and reconstruction. The distribution and degree of pulmonary embolism were observed and the pulmonary embolism index was calculated to analyze cardiac function. According to the embolization position, it is divided into two groups, the central type and the surrounding type. The differences in right heart function parameters between patients with or without pulmonary embolism were compared. The differences in cardiac function parameters between different embolization groups and embolization sites were compared. Results RVEDV and RVESV were higher in the pulmonary embolism group than in the non-embolized group，the RVEF value was lower than that in the non-embolized group（P＜0.05）; the RVSV was lower than the non-embolized group, and the difference between the two groups was not statistically significant（P＞0.05）. As the degree of embolization increased, RVEF gradually decreased, and the overall difference in RVEF between the three groups was statistically significant（P＜0.05）. The central type of RVEF was significantly lower than the surrounding type and non-embolized group. The difference of RVEF between the three groups was statistically significant（P＜0.05）. Conclusion CTPA can accurately evaluate the distribution, extent and embolism index of pulmonary embolism. The evaluated cardiac function also has certain value in clinical practice.

参考文献/References:

[1] van der Hulle T,Cheung WY,Kooij S,et al. Simplified diagnostic management of suspected?pulmonary embolism(the YEARS study):a prospective,multicentre,cohort study[J].Lancet,2017,390(10091):289-297.

[2] Murphy A,Cheng J,Pratap J,et al. Dual-energy computed tomography?pulmonary?angiography: comparison of vessel enhancement between linear blended and virtual monoenergetic reconstruction techniques [J].J Med Imaging Radiat Sci,2019,50(1):62-67.

[3] 陈晓艺,彭礼清,刘静,等. 双源计算机断层扫描评价卵圆孔未闭在心动周期中的动态特征[J].心血管病学进展杂志,2019,40(4):645-649.

[4] Guo ZJ,Liu HT,Bai ZM,et al.A new method of CT for the cardiac measurement:correlation of computed tomography measured cardiac parameters and pulmonary obstruction index to assess cardiac morphological changes in acute pulmonary embolism patients[J].J Thromb Thrombolysis,?2018,45(3):410-416.

[5] Liang HW,Zhao DL,Liu XD.ECG-gated pulmonary artery CTA for evaluation of right ventricular function in patients with acute pulmonary embolism[J].Echocardiography,2017,34(2):257-263.

[6] Gutte H,Mortensen J,M?rk ML.Non-ECG-gated CT pulmonary angiography and the prediction of right ventricular dysfunction in patients suspected of pulmonary embolism[J].Clin Physiol Funct Imaging,2017,37(6):575-581.

[7] Apfaltrer P,Henzler T,Meyer M,et.al. Correlation of CT angiographic pulmonary artery obstruction scores with right ventricular dysfunction and clinical outcome in patients with acute pulmonary embolism[J].EurJ Radiol,2012,81(10):2867-2871.

[8] Doherty S.Pulmonary embolism An update.Aust Fam Physician[J].2017；46(11)：816-820.

[9] Kausar S,Khan HS,Nazir MT,et.al.Acute Pulmonary Embolism: Presentation, Diagnosis, Management and Factors Impacting Clinical Outcome in a Tertiary Cardiac Centre in Pakistan[J].J Coll Physicians Surg Pak,2019,29(8):749-752.

[10] Becattini C,Agnelli G.Risk stratification and management of acute pulmonary embolism[J].Hematol Am Soc Hematol Educ Program,2016,2016(1):404-412.

[11] Keller K,Beule J,Coldewey M.Heart rate in pulmonary embolism[J].Intern Emerg Med, 2015 ,10(6):663-669.

[12] 边圆,陈玉国,徐峰. 急性心力衰竭诊治流程进展[J]. 心血管病学进展杂志 ,2018,38(2):113-118.

[13] Pinsky MR. The right ventricle:interaction with the pulmonary circulation[J].Crit Care, 2016,10(20):266.

[14] Dutta T,Frishman WH,Aronow WS.Echocardiography in the evaluation of pulmonary embolism[J].Cardiol Rev,2017,25(6):309-314.

[15] Barrios D,Morillo R,Lobo JL,et al.Assessment of right ventricular function in acute pulmonary embolism: a speckle tracking echocardiography-based study [J].Echocardiography,2017,185(5):123-129.

[16] Ramberg E,Olausson M,J?rgensen TB,et al.Right atrial and ventricular function evaluated with speckle tracking in patients with acute pulmonary embolism[J].Am J Emerg Med,2017,35(1):136-143.

[17] Varol K,Gumus C,Yucel H,et al. Correlation of right ventricular dysfunction on acute pulmonary embolism with pulmonary artery computed tomography obstruction index ratio (PACTOIR) and comparison with echocardiography[J].Jpn J Radiol,2015,33(6):311-316.

[18] Cok G,Tasbakan MS,Ceylan N,et al.Can we use CT pulmonary angiography as an alternative to echocardiography in determining right ventricular dysfunction and its severity in patients with acute pulmonary thromboembolism？[J].Jpn J Radiol,2013,31(3):172-178.

[19] Kang DK,Ramos-Duran L,Schoepf UJ,et al. Reproducibility of CT signs of right ventricular dysfunction in acute pulmonary embolism[J].AJR Am J Roentgenol,2010,194(6):1500-1506.

[20] Jia D,Zhou XM,Hou G.Estimation of right ventricular dysfunction by computed tomography pulmonary angiography:a valuable adjunct for evaluating the severity of acute pulmonary embolism[J].J Thromb Thrombolysis,2017,43(2):271-278.

[21] Osman AM,Abdeldayem EH.Value of CT pulmonary angiography to predict short-term outcome in patient with pulmonary embolism[J].Int J Cardiovasc Imaging,2018,34(6):975-983.

[22] Altmayer SP,Patel AR,Addetia K,et al. Cardiac MRI right ventricle/left ventricle(RV/LV) volume ratio improves detection of RV enlargement[J].J Magn Reson Imaging,2015,9(10):1-5.

相似文献/References:

[1]吴阳 杨桂荣 张波 陈各才.双源CT在左心耳封堵术前评估及指导选择WatchmanTM封堵器型号的应用[J].心血管病学进展,2021,(4):374.[doi:10.16806/j.cnki.issn.1004-3934.2020.04.020]
　WU Yang,YANG Guirong,ZHANG Bo,et al.The Application of Dual Source CT in Preoperative Evaluation of Left Atrial Appendage Occlusion and Size Selection of Watchman TM Occluder.com[J].Advances in Cardiovascular Diseases,2021,(6):374.[doi:10.16806/j.cnki.issn.1004-3934.2020.04.020]

备注/Memo

备注/Memo:
通讯作者：余建群，E-mail：cjr.yujianqun@vip. 163. com收稿日期：2019-08-03
更新日期/Last Update: 2019-12-17