肺栓塞的超声诊断价值探讨

目的探讨肺栓塞的超声诊断价值。方法将CT肺动脉血管造影(CTPA)诊断为肺栓塞的15例患者,行心脏、胸腔、四肢静脉的彩色多普勒超声检查。结果所有病例超声未发现肺栓塞的直接征象;但可发现一些间接征象如:6例发现右心增大,少~大量三尖瓣反流,肺动脉压升高;7例发现肺动脉血流流速曲线上的RPEP/RVET比值升高>0.30;2例发现肺部梗塞区;6例发现下肢静脉血栓形成;5例发现下肢静脉血流淤滞。结论超声发现肺栓塞直接征象的几率较低,不能作为确诊肺栓塞的主要检查方法。但超声能发现一些肺栓塞的间接征象,对临床的诊断、治疗和观察疗效有重要意义。

The preliminary value of ultrasound diagnosis on pulmonary embolism

Objective To explore the value of ultrasound diagnosis on pulmonary embolism. Methods The vein of limbs and the heart and the chest in 15 cases with pulmonary embolism diagnosed through CTPA were examined by ultrasound. Results There was no direct sign of pulmonary embolism in all cases, but some indirect signs can be discovered by ultrasound. There was right ventricular extand and tricuspid regurgitation and pulmonary hypertension in 6 cases. The proportion (RPEP/RVET) of pulmonary artery flow velocity curve was high (>0.3) in 7 cases. The infarction area of lung was discovered in 2 cases. The vein thrombosis of low limbs was discovered in 6 cases. The venous stasis of low limbs was discovered in 5 cases. Conclusions The probability of direct sign of pulmonary embolism discovered by ultrasound is low. So ultrasound can not be used as main examining method of diagnosis pulmonary embolism. But some indirect sign of pulmonary embolism can be discovered by ultrasound. It is significant to clinical diagnosis, treatment, and observing effectiveness.