CT肺动脉成像与急性肺栓塞严重程度及短期预后的相关性研究

doi:10.3969/j.issn.1006-6233.2024.06.020

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Abstract Objective: To evaluate the relationship between CT parameters of pulmonary artery and cardiac function and 30-day adverse prognosis in patients with acute pulmonary embolism, and to provide information for rapid risk stratification in patients with acute pulmonary embolism.Methods: A total of 243 patients who were diagnosed with acute pulmonary embolism by CTPA examination in our hospital and followed up for 30 days were retrospectively analyzed in this study. The ratio of the main pulmonary artery (MPA) to the aorta (AO), the maximum diameter of the left (LPA) and right (RPA) pulmonary artery, and the maximum short diameter ratio between the right and left ventricles (RVD/LVD) were measured on the transverse axis image, and the height and volume of the pulmonary trunk were measured at the workstation. The patients were grouped according to 30-day prognosis, the severity of pulmonary embolism, and embolism type, and various parameters were compared.Results: There were statistically significant differences between the two groups in terms of surgery or immobilization history, heart rate, pulmonary embolism type, and treatment methods (P<0.05); The LPA and RVD/LVD values in the poor prognosis group were greater than those in the good prognosis group (P<0.05); In the grouping based on the location and severity of the embolism, there were statistically significant differences between the two groups in terms of MPA/AO, MPA, RPA, LPA, PAV, PAOI, RVD/LVD, interventricular septal shift, and vena cava reflux (P<0.05); The ratio of right ventricular to left ventricular diameters (RVD/LVD) had the highest AUC value and specificity for predicting moderate to severe pulmonary embolism.Conclusion: The ratio of right ventricular to left ventricular diameters (RVD/LVD) can be used as the primary indicator for daily assessment of the prognosis of acute pulmonary embolism. The volume of the pulmonary artery trunk (PAV) can serve as a new indicator for determining the severity of acute pulmonary embolism. Additionally, MPA, RPA, LPA, vena cava reflux, and interventricular septal shift have certain predictive values for the severity of pulmonary embolism, providing a more reliable basis for clinical personalized treatment plans.

Key words： Pulmonary artery CTA Pulmonary embolism Adverse prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.06.020 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I6/980

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