双源CT与DSA在急诊肺栓塞患者诊断中应用研究

目的研究双源CT与肺动脉造影(DSA)在急诊肺栓塞(APE)患者诊断中的应用价值。方法选取2013年5月至2014年12月我院收治的APE患者50例入研究组,另50例非动脉栓塞患者为对照组,均行双源CT双能量肺动脉成像(CTPA)与DSA,对比其血管测量参数值、肺动脉压力及右心室/左心室最大横径比(RVd/LVd)、最大面积比(RVa/LVa),比较双源CT、DSA诊断APE的灵敏度、特异度、准确度,评价影像特征。结果研究组肺动脉压力(49.92±1.68)mm Hg、RVd/LVd(1.24±0.31)及RVa/LVa(1.20±0.39)高于对照组(P0.05);两组升主动脉直径比较无显著差异(P0.05),研究组主肺动脉直径(31.04±1.58)mm、左肺动脉直径(22.57±1.84)mm、右肺动脉直径(25.29±1.64)mm及右下肺动脉直径(14.29±1.07)mm高于对照组(P0.05);双源CT诊断APE的灵敏度86.67%、特异度100.00%、准确度88.00%与DSA比较无显著差异(P0.05)。结论双源CT与DSA在APE中具有较高应用价值,其中双源CT的CTPA可较好显示肺部解剖信息,而DSA可预测肺动脉高压及肺功能,为APE的诊断提供依据。

Application of Dual-source CT and DSA in the Diagnosis of Acute Pulmonary Embolism

Objective To study the application value of dual-source CT and digital subtraction angiography (DSA) in the diagnosis of acute pulmonary embolism (APE). Methods From May 2013 and December 2014, 50 patients with APE (study group) and 50 patients without APE (control group) in our hospital were enrolled in the study. All subjects underwent dual-source CT pulmonary angiography (CTPA) and DSA. The vascular parameters, pulmonary artery pressure, the maximum right ventricular/left ventricular transverse diameter ratio (RVd/LVd) and maximum area ratio (RVa/LVa) were compared between the two groups. The sensitivity, specificity and accuracy of dual-source CT and DSA in the diagnosis of APE were analyzed, and the imaging findings were evaluated.Results The pulmonary artery pressure [(49.92±1.68) mmHg], RVd/LVd (1.24±0.31) and RVa/LVa (1.20±0.39) of the study group were higher than those of the control group (P<0.05). There was no significant difference in the diameter of ascending aorta between the two groups (P>0.05). The diameters of main pulmonary artery [(31.04±1.58) mm], left pulmonary artery [(22.57±1.84) mm], right pulmonary artery [(25.29±1.64) mm] and right lower pulmonary artery [(14.29±1.07) mm] of the study group were higher than those of the control group (P<0.05). There were no significant differences in the sensitivity, specificity and accuracy between dual-source CT (86.67%, 100.00%, 88.00%) and DSA (91.11%, 100.00%, 92.00%) in the diagnosis of APE (P>0.05). Conclusion Both of dual-source CT and DSA have high application value in the diagnosis of APE. CTPA of dual-source CT can well show the anatomical information of lungs, while DSA can predict high pulmonary arterial pressure and pulmonary function, providing effective basis for the diagnosis of APE.