CAJ | 학술논문

目的探讨双源CT(DSCT)对急性大面积肺栓塞患者右心室功能不全(RVD)的诊断价值.方法回顾性分析40例经DSCT检查证实为急性大面积肺栓塞患者的临床资料.DSCT定性诊断RVD的指标有:心脏横轴观显示右心室扩大、室间隔变直或向左室内凸出,患者均在行DSCT检查前或检查后48 h内行心脏超声心动图检查.以超声心动图结果为参照标准,比较分析DSCT定性方法诊断肺栓塞患者RVD的敏感性、特异性、阳性预测值、阴性预测值及两种检查方法结果的一致性.结果 40例急性大面积肺栓塞患者中,DSCT定性诊断RVD 30例,超声心动图诊断右心功能不全34例,DSCT定性诊断急性大面积肺栓塞患者RVD的敏感性为88.2％,特异性为100％,阳性预测值为100％,阴性预测值60％,Kappa值为0.692,P＞0.05,故两种检查方法对急性大面积肺栓塞患者右心室功能不全的诊断差异无统计学意义,具有较好的一致性.结论采用DSCT定性方法能迅速、准确地评估急性肺栓塞患者的右心室功能,是一种既简单又实用的方法,有利于指导临床治疗和预测患者预后.
목적 탐토쌍원CT(DSCT)대급성대면적폐전새환자우심실공능불전(RVD)적진단개치.방법 회고성분석40례경DSCT검사증실위급성대면적폐전새환자적림상자료.DSCT정성진단RVD적지표유:심장횡축관현시우심실확대、실간격변직혹향좌실내철출,환자균재행DSCT검사전혹검사후48 h내행심장초성심동도검사.이초성심동도결과위삼조표준,비교분석DSCT정성방법진단폐전새환자RVD적민감성、특이성、양성예측치、음성예측치급량충검사방법결과적일치성.결과 40례급성대면적폐전새환자중,DSCT정성진단RVD 30례,초성심동도진단우심공능불전34례,DSCT정성진단급성대면적폐전새환자RVD적민감성위88.2％,특이성위100％,양성예측치위100％,음성예측치60％,Kappa치위0.692,P＞0.05,고량충검사방법대급성대면적폐전새환자우심실공능불전적진단차이무통계학의의,구유교호적일치성.결론 채용DSCT정성방법능신속、준학지평고급성폐전새환자적우심실공능,시일충기간단우실용적방법,유리우지도림상치료화예측환자예후.
Objective To investigate the diagnostic value of Dual-source CT(DSCT) with qualitative method in detecting fight ventricular dysfunction in patients with acute massive pulmonary embolism.Methods The clinical data of 40 patients with acute massive pulmonary embolism confirmed by DSCT were retrospectively analyzed.The DSCT diagnosis standards of right ventricular dysfunction were following:the right ventricle was dilated or there was leftward shift of the interventricular septum or ventricular septal straighted.Echocardiography were performed in all patients in 48 hours before or after DSCT inspection.Echocardiographic reports serving as the reference standard.Comparative analysis the sensitivity,specificity,positive predictive value,negative predictive value and the consistency of results of the two methods with DSCT qualitative in detecting right ventricular dysfunction in patients with acute massive pulmonary embolism.Results Among the 40 patients with acute massive pulmonary embolism,30 patients with right ventricular dysfunction in the DSCT image,34 patients with right ventricular dysfunction in echocardiography.The results of the sensitivity,specificity,positive predictive value and negative predictive value'with DSCT qualitative methods in detecting right ventricular dysfunction in patients with acute massive pulmonary were 88.2％,100％,100％,60％,respectively,K =0.692.P ＞0.05).Therefore,there was no significant difference between the two diagnosis methods of acute massive pulmonary embolism in patients with right ventricular dysfunction.Moreover,the diagnosis of the two methods has a good consistency in detecting fight ventricular dysfunction in patients with acute massive pulmonary.Conclusions Using DSCT qualitative method can assess right ventricular dysfunction in patients with acute massive pulmonary embolism quickly and accurately,and which is a simple and practical method,and is useful to guide clinical treatment and to predict the prognosis.