摘要
目的量化临床疑似冠心病住院患者冠状动脉CT成像(CCTA)图像上肺栓塞的意外检出率,并初步探讨意外检出肺栓塞的特征及原因。方法选择临床疑似冠心病并接受CCTA检查的住院患者4609例,最后入选4177例,其中年龄<60岁患者1730例,≥60岁患者2447例。观察图像并记录每个患者的肺动脉强化程度和有无肺栓塞。结果意外检出肺栓塞56例(1.3%)。肺栓塞意外检出率随着年龄增长而升高,年龄<60岁检出率为0.6%,≥60岁检出率增至1.8%(P<0.05)。56例肺栓塞中,37例(66.1%)仅累及肺段和肺亚段动脉,阵发性心房颤动(房颤)包括有房颤病史和心功能不全患者,其肺栓塞意外检出率(3.9%、4.9%)虽高于未合并房颤和心功能不全患者(1.1%,1.1%)的检出率,但差异无统计学意义(P>0.05)。50例肺栓塞患者中,下肢静脉血栓7例(14.0%),53例肺栓塞患者中,10例D-二聚体水平>0.50mg/L(18.9%)。结论住院患者CCTA图像上肺栓塞的意外检出率较低,并具有与"典型"肺栓塞不同的特征。每一个影像医师都应常规利用CCTA图像评价是否存在肺栓塞,尤其是合并房颤包括有房颤病史或心功能不全的老年住院患者。
Objective To study the features and causes of pulmonary embolism （PE） unexpectly detected by coronary CT angiography （CCTA） in patients with suspected coronary heart disease （CHD）. Methods A total of 4177 patients with suspected CHD who undetrwent CCTA in our hospital were divided into 〈60 years old group （n=1730） and ≥60 years old group （n=2447）. Pulmonary artery enhancement and presence or absence of PE on their CCTA images were recor- ded. Results PE was detected in 56 patients（1.3%）. The PE detection rate that increased with the age was higher in ≥60 years old group than in 〈60 years old group （1.8%vs 0.6%,P〈0.05）. Of the 56 PE patients,37 （66.1%） were found to have their segmental and subsegmental pulmonary artery involved. The PE detection rate was no significantly higher in patients with par- oxysmal atrial fibrillation （AF） or its history and cardiac insufficiency than in those without AF or cardiac insufficiency （3.9%,4.9% vs 1.1%,1.1%,P〉0.05）. Of the 50 PE patients,7 （14.0%） had lower extremity vein thrombosis. Of the 53 PE patients,10 （18.9%） had their D-dimer vol- ume 〉0.50 mg/L. Conclusion The unexpectly detected rate of PE is low in patients with suspec- ted CHD on their CCTA images. The features of PE are different from those of typical PE. CCTA images should be used by every radiologist in assessment of PE in elderly CHD patients, especially in those with AF or its history and cardiac insufficiency.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2013年第7期697-700,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
冠心病
体层摄影术
X线计算机
肺栓塞
心房颤动
住院病人
coronary disease
tomography, X-ray computed
pulmonary embolism
atrial fibrilla-tion
inpatients
