Research Of Embolization Area And The Diameter Of Pulmonary Vascular In204Patients With Pulmonary Embolism

Objective: To explore the relationship between embolization area,diameter of pulmonary vessels with pulmonary arterial pressure in patientswith APTE by CTPA.Methods:1Research objectsThe patients’ datas were collected from January2012to March2013inthe Second Hospital of Hebei Medical University. Patients were confirmed byCTPA in3months, they have no cardiopulmonary disease and immunologicaldisease and other various reasons caused pulmonary hypertension. Dividingstandard:PASP<36mmHg(groupⅠ),36-40mmhg(groupⅡ),41-70mmHg(groupⅢ),>70mmHg(group Ⅳ),PASP was calculated from UCG.We counted allresearch gender, age, height, weight, BMI.2The correlation between RV/LV with PASP assessed by UCGWe measure the PASP by tricuspid regurgitation in UCG, and measuredRV, LV, RV/LV, then to assess the correlation compare to PASP and thedifference in four groups.3With a standard diagnosed by UCG, we estimated the sensitivity andspecificity of CTPA in the diagnosis of PAHWe took the PASP>36mmHg as a diagnostic standard of PAH, to assessthe sensitivity and specificity of PA/AA>1diagnosed by CPTA.4The correlation between the diameter of pulmonary vessels with PASPassessed by CTPAWe measured PA, PA/AA, RPA and vertebral body diameter at CTPA,then to assess the correlation compare to PASP and the difference in fourgroups. 5The correlation between the embolization area with PASP assessed byCTPAWe calculated the cmbolization area according to the segmental andsubsegmental pulmonary embolism branches and embolization degree, then toassess the correlation compare to PASP and the difference in four groups.Results:1The basic characteristics of the patientsIt is found that there are120,14,48,22person in the four groups, male is44.9%and the female is54.6%, those who older than65y is74.02%, there isno difference in gender, age, height, weight and BMI.2The correlation between RV/LV with PASP assessed by UCGFour groups of patients respectively in RV/LV is (0.55±0.32),(0.46±0.22),(0.66±0.23),(1.49±3.55), there is positive correlation betweenRV/LV and PASP(R=0.396), and the RV/LV ratio gradually increase with theincrease of PASP. The comparison between groups is that there is nodifference between groupⅠand Ⅱ,the same to group Ⅲ and Ⅳ.3With a standard diagnosed by UCG, we estimated the sensitivity andspecificity of CTPA in the diagnosis of PAHThe sensitivity of CTPA on diagnostic PAH is about70%. The sensitivityin the diagnosis of sever PAH is81.2%.4The correlation between the diameter of pulmonary vessels with PASPassessed by CTPAFour groups of patients respectively in PA is (28.8±5.03)mm,(30.8±4.01)mm,(32.5±6.67)mm,(35.5±5.76)mm, there is positive correlationbetween PA and PASP(R=0.35), and the PA gradually increase with theincrease of PASP. The comparison between groups is that there is nodifference between group Ⅱ and Ⅲ.Four groups of patients respectively in PA/AA is (0.91±0.17),(0.97±0.16),(1.07±1.77),(1.07±0.11), there is positive correlation betweenPA/AA and PASP(R=0.46), and the PA/AA gradually increase with the increase of PASP. The comparison between groups is that there is nodifference between groupⅠand Ⅱ,the same to group Ⅲ and Ⅳ.Four groups of patients respectively in RPA is (20.14±4.48)mm,(17.94±2.51)mm,(20.05±3.47)mm,(23.25±4.74)mm, there is positivecorrelation between RPA and PASP(R=0.13), and the RPA gradually increasewith the increase of PASP. The comparison between groups is that there isdifference between sever patients and non-severe patients.Four groups of patients respectively in PA/vertebral is (1.33±0.37)mm,(1.48±0.42)mm,(1.47±0.38)mm,(1.63±0.34)mm, there is positive correlationbetween PA/vertebral and PASP(R=0.25), and the PA/vertebral graduallyincrease with the increase of PASP. The comparison between groups is thatthere is no difference between group Ⅱ and Ⅲ.5The correlation between the embolization area with PASP assessed byCTPAFour groups of patients respectively in embolization area is(17.72±13.61),(18.25±13.78),(33.39±10.99),(40.64±15.75), there is positivecorrelation between embolization area and PASP(R=0.25), and the PASPgradually increase with the increase of embolization area. The comparisonbetween groups is that there is no difference between group Ⅰ and Ⅱ.Conclusion:1The morbidity of PAH in female is higher than male.2The RV/LV ratio gradually increase with the increase of PASP,RV/LV>0.66can cause moderate or severe PAH.3The sensitivity of diagnosing on PAH by CTPA is70.2%, in mild PAHis28.6%, moderate is77.1%, severe is81.2%;the specificity is72.5%.4Once the PAH forms, its PA diameter is usually more than30mm andthe PA diameter are more than35mm when the severe PAH forms; pulmonaryartery pressure increase can cause the change of RPA; PA/AA>1can beregarded as the judgment standard on moderate and severe PAH, butPA/AA<1can not exclude PAH; pulmonary artery pressure increase can causethe change of PA/vertebral. 5When the embolization area greater than33%indicates PASP is greaterthan41mmHg, the embolization area greater than40%indicates PASP isgreater than70mmHg.