DSCT Diagnosis Of Acute Pulmonary Arterial Thromboem-bolism And Evaluation Of Curative Effect

Objective:By retrospective analysis of DSCT in acute pulmonary thromboembolism and the imaging changes after different treatments, to study on DSCT in diagnosis of acute pulmonary embolism and the value of follow-up after treatment, comparative analysis of the effectiveness of various treatments to enhance awareness of the diagnosis and treatment of acute pulmonary thromboembolism, increase the rate of early diagnosis and treatment, and reduced missed diagnosis, misdiagnosis, mortality.Materials and Methods:Retrospective analysis of47cases of acute pulmonary embolism patients admitted to our hospital. All the patients before treatment were examined by DSCTPA, and at least2review after treatment in7days to2months;20cases underwent thrombolytic therapy,18cases underwent anticoagulant therapy,9cases of interventional therapy. First, analysis of DSCT:(1) Pulmonary embolism embolism position and embolic form;(2) Embolism artery diameter measurement;(3) The different processing technology on all levels of detectable rate of pulmonary lesions. Second,On the basis of clinical symptoms improved and imaging changes, comparing and comprehensive analysis different treatment schemes of effective: efficacy evaluation into the void (no change, deterioration and death), effective and slightly effective.(1) The invalid:clinical symptoms without apparent ease, after treatment showed no change in CT embolus. Deterioration (including death):clinical symptoms were more serious than before, after treatment than before, CT prompts embolus increase increase.(2) Efective:clinical symptoms significantly reduced after treatment, CT,1/2≥embolus decrease narrowing;(3) Slightly effective: clinical symptoms after treatment, CT,1/4≥embolus reduce reduced. Data using Excel data entry and using SPSS17.0statistics software package for data analysis, Chi-square test, rank sum test.Result:First, imaging:(1) The right pulmonary artery involved in281, involving the left pulmonary artery in101, double lower lobe artery involved in256, double lung middle and upper lobe artery involved in94, right pulmonary artery embolism is common than left pulmonary artery, double lower lobe pulmonary artery embolism is common in lung; Emboli performanced saddle-syndrome, floating-syndrome, track-sign,ring-syndrome, thrombus is free in pulmonary artery, prompting fresh thrombus (34/47,75.56%).(2) Most embolism artery widened diameter (293/385,76.10%), blood vessel diameter did not change in23.90%;(3) In the1stage arterial pulmonary embolism detection rate of MPR, MIP, VR three kinds of treatment without any distinction; MPR detection rate is higher than that of MIP and VR in2-3stage arterial, but the result was not statistically significant (P=0.13); the detection rate is higher in the4-5stage arterial MPR, MIP and VR were significantly difference with, with statistical significance (P<0.001); Second,curative effect contrast:There were significant differences comparing the thrombolysis group, anticoagulant group of significant efficiency and intervention group (P<0.001); interventional group efficiency and thrombolysis group and anticoagulation group with significant difference (P<0.001); the total efficiency with anticoagulant group, intervention group thrombolysis group three the difference between groups was not significant.Conclusion:First, imaging:(1) High incidence of acute pulmonary embolism in right lung than the left lung, double lower lung more than double upper lungs. Emboli performanced saddle-syndrome, floating-syndrome, ring-syndrome,track-sign, prompting fresh thrombus.(2) Most embolism vascular diameter is widened.(3) In the1stage of pulmonary embolism detection rate of MPR, MIP, VR three kinds of treatment without any distinction; MPR detection rate is higher than that of MIP and VR in2-3pulmonary artery; MPR detection rate was significantly higher than that of MIP and VR in4-5pulmonary artery. Second, curative effect evaluation:Pure anticoagulation, thrombolysis and interventional treatment is an effective method for treatment of acute PTE, acute massive pulmonary embolism interventional therapeutic effective rate was higher than that of the former two, but also has high risk.Third,DSCT is the diagnosis and treatment of acute pulmonary embolism after the first choice of imaging follow-up examination.