摘要
目的分析双源CT双能量成像(dual energy perfusion imaging,DEPI)联合高敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)、D-二聚体(D-dimer,D-D)检测对周围型肺动脉栓塞的诊断价值。方法选取海南医学院第二附属医院2015年3月至2018年6月收治的171例临床疑似周围型肺动脉栓塞患者为研究对象,分别行CT肺动脉造影(CT pulmonary angiography,CTPA)、DEPI检查,检测患者血清hs-CRP、D-D水平,以CTPA结合病理检查结果作为周围型肺动脉栓塞诊断的金标准,计算DEPI及其联合hs-CRP、D-D水平检测对周围型肺动脉栓塞的诊断价值。结果171例患者中,共有87例诊断为周围型肺动脉栓塞,单纯CTPA检出率为56.32%(49/87)。87例周围型肺动脉栓塞患者共检出栓子159个,CTPA对亚段以下动脉栓子检出率显著低于CTPA+肺灌注血容量(lung perfusion blood volume,Lung PBV)和CTPA+肺血管(Lung Vessels)(均P<0.05)。周围型肺动脉栓塞患者血清hs-CRP、D-D水平均显著高于非周围型肺动脉栓塞患者(均P<0.05)。hs-CRP+D-D诊断周围型肺动脉栓塞的灵敏度较高,但特异度偏低;DEPI联合hs-CRP、D-D水平检测周围型肺动脉栓塞的灵敏度、特异度分别为92.13%、79.62%。结论DEPI联合hs-CRP、D-D水平检测对周围型肺动脉栓塞的诊断效能值得肯定,对亚段以下动脉栓子的检出率优于CTPA。
Objective To analyze the diagnostic value of dual energy perfusion imaging(DEPI)combined with high-sensitivity C reactive protein(hs-CRP)and D-dimer(D-D)detection in the diagnosis of peripheral pulmonary embolism.Method 171 patients with clinically suspected peripheral pulmonary embolism admitted to the Second Affiliated Hospital of Hainan Medical College from March 2015 to June 2018 were examined by CT pulmonary angiography(CTPA),DEPI and serum hs-CRP and D-D detection.CTPA combined with pathological examination results was regarded as the gold standard for the diagnosis of peripheral pulmonary embolism.The diagnostic efficiency of DEPI and hs-CRP,D-D detection in the diagnosis of peripheral pulmonary embolism were calculated.Result Of the 171 patients,87 cases were diagnosed as peripheral pulmonary embolism,and the detection rate of CTPA alone was 56.32%(49/87).A total of 159 emboli were detected in 87 patients with peripheral pulmonary embolism.The detection rate of subsegment emboli by CTPA was lower than that by CTPA combined with lung perfusion blood volume(Lung PBV)and CTPA combined with Lung Vessels(all P<0.05).The levels of hs-CRP and D-D of patients with peripheral pulmonary embolism were higher than those of patients with non-peripheral pulmonary embolism(P<0.05).The sensitivity of hs-CRP+D-D in the diagnosis of peripheral pulmonary embolism was high,but the specificity was low.The sensitivity and specificity of DEPI combined with hs-CRP and D-D detection in the diagnosis of peripheral pulmonary embolism were 92.13%and 79.62%,respectively.Conclusion The clinical efficacy of DEPI combined with hs-CRP and D-D detection in the diagnosis of peripheral pulmonary embolism is worth affirming,and the detection rate of subsegment arterial emboli is better than CTPA.
作者
卫旭瑛
白峥嵘
陈艳
Wei Xuying;Bai Zhengrong;Chen Yan(Department of Radiology,the Second Affiliated Hospital of Hainan Medical College,Haikou 570102,China;Department of Radiology,Yan'an People's Hospital,Shaanxi,Yan'an 716000,China)
出处
《中国医学前沿杂志（电子版）》
2020年第7期156-160,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
海南省自然科学基金(20158324)。
