文章摘要
Jianguo Wang, Li Zhu,Min Liu,Xiaojuan Guo,Chen Wang,Youmin Guo,Yuanhua Yang, Zhenguo Zhai,Hongxia Ma, Yulin Guo.[J].南京医科大学学报,2008,28(4):234~237
The value of CT pulmonary angiography to the diagnosis of right ventricular dysfunction due to acute pulmonary embolism: compared with ultrasonographic cardiography
投稿时间:2008-04-10  
DOI:10.7655
中文关键词: 
英文关键词: pulmonary embolism  tomography  X-ray computed  angiography
基金项目:
作者单位
Jianguo Wang Imaging Center, the Second Hospital of Medical College of Xi’an Jiao Tong University, Xi’an, 710004,Shaanxi Province,China 
Li Zhu Imaging Center, Affiliated Hospital of NingXia Medical College,Yinchuan,750004, Ningxia Hui Autonomous Region,China 
Min Liu Radiology department, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100020, China 
Xiaojuan Guo Radiology department, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100020, China 
Chen Wang Respiratory Medicine, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100020, China 
Youmin Guo Radiology department, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100020, China 
Yuanhua Yang Radiology department, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100020, China 
Zhenguo Zhai Respiratory Medicine, Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100020, China 
Hongxia Ma Imaging Center, Affiliated Hospital of NingXia Medical College,Yinchuan,750004, Ningxia Hui Autonomous Region,China 
Yulin Guo Imaging Center, Affiliated Hospital of NingXia Medical College,Yinchuan,750004, Ningxia Hui Autonomous Region,China 
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中文摘要:
      
英文摘要:
      Objective:To analyze the value of CT pulmonary angiography(CTPA) in assessing right ventricular dysfunction(RVD) after acute pulmonary embolism. Methods:Thirty-six patients with CTPA-confirmed PE who underwent ultrasonic cardiography(UCG) within the ensuing 24 hours were retrospectively reviewed. According to the severity of the disease, the patients were divided into the massive PE group(24 cases) and non-massive PE group(12 cases) respectively. CT scans were analyzed for findings suggestive of RVD. Scans were considered positive for RVD if the right ventricle was dilated(RVd/LVd>1) or if the interventricular septum was straightened or deviated towards the left ventricle. Results were then compared with the results of UCG to estimate the value of CTPA in detecting RVD associated with PE. Results:In all cases, compared with UCG, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value of CTPA was 84.61%, 78.26%, 3.892, 0.197, 68.75% and 90% respectively. Kappa value was 0.60, which suggested moderate agreement between CTPA and UCG in the whole level. In the massive PE group, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value of CTPA was 84.61%, 72.73%, 3.103, 0.212, 78.57% and 80% respectively. Kappa value was 0.58, which suggested moderate agreement between CTPA and UCG in the massive PE group. In the non-massive PE group, the diagnostic specificity of CTPA was 83.33%. By statistics, the value of RVd/LVd had significant difference between the massive PE and the non-massive PE group. Conclusion:CTPA can reliably detect RVD through the evaluation of cardiac morphology. However, this result requires confirmation using a larger prospective cohort study.
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