双源CT肺动脉成像对急性肺栓塞危险分层及预后的预测价值OA
Predictive value of dual-source CT pulmonary angiography in risk stratification and prognosis of patients with acute pulmonary embolism
目的:探讨双源CT肺动脉成像(CTPA)对急性肺栓塞(APE)危险分层及预后的预测价值.方法:回顾性分析152例临床疑诊APE患者,按临床确诊结果分为APE组(84例)与非APE组(68例).按危险分层将APE患者分为低危组(45例)与高危组(39例),按预后情况将APE患者分为预后良好组(59例)与预后不良组(25例).全部患者均行双源CTPA检查,采用单因素及多因素logistic回归分析筛选出APE患者危险分层及预后的危险因素.采用ROC曲线评估双源CTPA参数对APE患者危险分层及预后的预测效能.结果:APE组右心室与左心室内径比(RVD/LVD)、主肺动脉内径(MPAD)、主肺动脉与主动脉内径比(MPAD/AD)、肺动脉栓塞指数(PAOI)及室间隔移位占比均高于非APE组(均P<0.05).高危组年龄、RVD/LVD、MPAD、MPAD/AD、PAOI均高于低危组(均P<0.05).预后不良组年龄、RVD/LVD、MPAD、PAOI均高于预后良好组(均P<0.05).多因素logistic回归分析显示,年龄、RVD/LVD、MPAD、PAOI均为APE危险分层及预后的独立危险因素(均P<0.05).ROC曲线显示,RVD/LVD、MPAD、PAOI单独及联合预测APE危险分层的AUC分别为0.801、0.790、0.738、0.888,预测APE预后的AUC分别为0.797、0.811、0.808、0.870.结论:双源CTPA相关参数RVD/LVD、MPAD、PAOI明显升高,可作为APE危险分层及预后评估的指标,三者联合的预测价值较高.
Objective:To explore the predictive value of dual-source CT pulmonary angiography(CTPA)in risk stratification and prognosis of patients with acute pulmonary embolism(APE).Methods:A total of 152 patients with suspected APE were retrospectively analyzed and divided into the APE group(84 cases)and non-APE group(68 cases)according to clinical diagnosis results.And then the APE patients were divided into the low-risk group(45 cases)and high-risk group(39 cases)according to risk stratification.According to prognosis,the APE patients were divided into the good-prognosis group(59 cases)and poor-prognosis group(25 cases).All patients underwent dual-source CTPA examination.Univariate analysis and multivariate logistic regression analyses were performed to identify the risk factors associated with risk stratification and prognosis in APE patients.The ROC curve was used to evaluate the predictive performance of dual-source CTPA parameters for risk stratification and prognosis.Results:The ratio of right ventricular diameter to left ventricular diameter(RVD/LVD),main pulmonary artery diameter(MPAD),ratio of MPAD to aorta diameter(MPAD/AD),pulmonary artery obstruction index(PAOI)and ventricular septal displacement ratio in the APE group were higher than those in the non-APE group(all P<0.05).The age,RVD/LVD,MPAD,MPAD/AD and PAOI in the high-risk group were higher than those in the low-risk group(all P<0.05),and age,RVD/LVD,MPAD and PAOI in the poor-prognosis group were higher than those in the good-prognosis group(all P<0.05).The logistic regression analysis showed that age,RVD/LVD,MPAD and PAOI were the independent risk factors associated with risk stratification and prognosis of APE(all P<0.05).The ROC curves showed that the AUC values of risk stratification in APE predicted by RVD/LVD,MPAD,PAOI alone and combined were 0.801,0.790,0.738 and 0.888,respectively,and the AUC values of the prognosis were 0.797,0.811,0.808 and 0.870,respectively.Conclusions:The significant increase in dual-source CTPA-related parameters(RVD/LVD,MPAD and PAOI)in APE patients can be served as useful indicators for risk stratification and prognostic evaluation.The combination of the three parameters provides high predictive value for both risk stratification and prognosis in APE patients.
伍秋会;冯浩;胡琼;杨娟;任晓翠;陈均
广元市第一人民医院放射科,四川 广元 628017广元市第一人民医院放射科,四川 广元 628017广元市第一人民医院放射科,四川 广元 628017广元市第一人民医院放射科,四川 广元 628017广元市第一人民医院放射科,四川 广元 628017广元市第一人民医院心胸外科,四川 广元 628017
医药卫生
急性肺栓塞体层摄影术,X线计算机危险分层预后
Acute pulmonary embolismTomography,X-ray computedRisk stratificationPrognosis
《中国中西医结合影像学杂志》 2026 (1)
59-63,5
四川省科技计划项目(2021YC00500).
评论