摘要
目的探讨CT血管成像对急性肺动脉栓塞(APE)的诊断评估价值。方法回顾性分析,收集2021年5月至2024年12月于信阳市光山县人民医院就诊的214例临床疑似APE患者的临床资料,根据临床综合诊断结果分为APE组(n=172)与非APE组(n=42)。患者均接受CT血管成像检查,以临床综合诊断结果为“金标准”,分析CT血管成像诊断结果APE的价值;根据APE患者病情严重程度分为低危组(n=48)、中低危组(n=65)和中高危组(n=59),分析CT血管成像相关参数对APE病情严重程度的诊断效能。结果以临床综合诊断结果为“金标准”,CT血管成像检出158例APE,CT血管成像检查APE结果与临床综合诊断结果的一致性较好(Kappa=0.786,P<0.001);诊断APE的灵敏度、特异度分别为91.86%(158/172)、95.24%(40/42)。中高危组主肺动脉与胸主动脉直径比(PAD/AOD)、右心室与左心室直径比(RVD/LVD)均高于中低危组、低危组(P<0.05);但中低危组、低危组组间PAD/AOD、RVD/LVD水平比较,差异无统计学意义(P>0.05)。绘制受试者工作特征(ROC)曲线,结果显示,PAD/AOD、RVD/LVD诊断评估中高危及非中高危APE的AUC值均≥0.7,均有一定预测价值,其中联合检测诊断价值AUC=0.917更为理想。结论CT血管成像鉴别诊断APE的灵敏度、特异度均高;获取的相关参数PAD/AOD、RVD/LVD可协助医师早期评估APE患者疾病严重程度。
Objective To evaluate the diagnostic performance of CT angiography(CTA)for acute pulmonary embolism(APE)and to explore its value in assessing disease severity.Methods In this retrospective analysis,clinical data of 214 patients with suspected APE admitted to Guangshan County People′s Hospital in Xinyang from May 2021 to December 2024 were reviewed.According to the clinical comprehensive diagnosis results,they were divided into APE group(n=172)and non-APE group(n=42).All patients underwent CTA,and the clinical comprehensive diagnostic results were used as the“gold standard”to analyze the value of APE in CTA diagnosis.According to the severity of APE patients,they were further stratified into low-risk group(n=48),intermediate-low-risk group(n=65),and intermediate-high-risk group(n=59),and the diagnostic efficacy of CTA related parameters on the severity of APE was analyzed.Results Using the clinical comprehensive diagnosis as the“gold standard”,CTA identified 158 APE cases.The consistency between CTA and the clinical comprehensive diagnosis was good(Kappa=0.786,P<0.001).The sensitivity and specificity of CTA for diagnosing APE were 91.86%(158/172)and 95.24%(40/42),respectively.The diameter ratio of the main pulmonary artery to the thoracic aorta(PAD/AOD)and the diameter ratio of the right ventricle to the left ventricle(RVD/LVD)in the intermediate-high-risk group were higher than those in the intermediate-low-risk group and low-risk group(P<0.05).However,there was no statistically significant difference in the levels of PAD/AOD and RVD/LVD between the low-risk and intermediate-low-risk groups(P>0.05).Receiver operating characteristic(ROC)curves for subjects were drawn,and the results showed that the AUC values of high-risk and non-intermediate-high risk APE in PAD/AOD and RVD/LVD diagnostic evaluations were all≥0.7,indicating certain predictive value.Among them,the combined detection had a more ideal diagnostic value(AUC=0.917).Conclusion CTA has high sensitivity and specificity in the differential diagnosis of APE.The derived parameters PAD/AOD and RVD/LVD can assist physicians in the early assessment of disease severity in APE patients.
作者
高建
徐梅
鲁小波
Gao Jian;Xu Mei;Lu Xiaobo(Department of CT Diagnosis,Guangshan County People′s Hospital,Xinyang 465450,China)
出处
《实用医技杂志》
2026年第2期118-122,I0003,共6页
Journal of Practical Medical Techniques
关键词
计算机体层摄影血管造影术
CT血管成像
肺栓塞
诊断
Computed tomography angiography
Computed tomograph angiography
Pulmonary embolism
Diagnosis
