能谱CT成像技术在心源性肺水肿中的诊断价值
Application and differential diagnostic value of energy spectrum CT imaging in cardiogenic pulmonary edema

段斌.能谱CT成像技术在心源性肺水肿中的诊断价值[J].内科急危重症杂志,2019,25(1):29-30

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DOI：10.11768/nkjwzzzz20190109

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基金项目:2010年湖北省自然科学基金项目（No：2010CDB09103）

作者	单位	E-mail
段斌	十堰市太和医院（湖北医药学院附属医院）	4728154194qq.com

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中文摘要:

目的：探讨能谱CT成像在心源性肺水肿中的临床诊断价值。方法：选取80例肺水肿患者，按照抛硬币法随机分成观察组（40例）和对照组（40例），2组在治疗前均行右心漂浮导管测定肺毛细血管楔压，观察组在治疗前、后均行胸部能谱CT平扫。比较2种检查方法对诊断心源性肺水肿的临床价值；观察治疗前、后患者能谱CT征象变化情况。结果：观察组患者中诊断出32例心源性肺水肿患者，排除8例。对照组患者中诊断出29例心源性肺水肿患者，排除11例。2组患者诊断结果比较，差异无统计学意义（P>0.05）。治疗后，具备肺血重分布征象患者较治疗前无明显变化（P>0.05）;具备胸膜下线、支气管血管束增粗、纤细网纹状影、小叶间隔增厚、磨玻璃样改变等征象情况的患者较治疗前出现明显减少（均P<0.05）。结论：能谱CT在鉴别心源性肺水肿中具有一定诊断价值。

英文摘要:

Objective: To explore the clinical value of energy spectrum CT imaging in the diagnosis and treatment of cardiogenic pulmonary edema. Methods: Eighty patients with pulmonary edema were divided into observation group (40 cases) and control group (40 cases) according to coin tossing method. The wedge pressure of pulmonary capillary was measured by right heart floating catheter in both groups before and after treatment. The observation group was scanned by chest energy spectrum CT before and after treatment. The clinical value of two methods in the diagnosis of cardiogenic pulmonary edema was compared, and the changes of energy spectrum CT signs before and after treatment were observed. Results: Thirty-two cases of cardiogenic pulmonary edema were diagnosed in the observation group, and 8 cases were excluded. In the control group, 29 cases of cardiogenic pulmonary edema were diagnosed and 11 cases were excluded. There was no significant difference in the diagnostic results between the two groups (P<0.05). There was no significant change in pulmonary blood redistribution signs before and after treatment (P>0.05). The number of patients with subpleural, bronchial vascular bundle enlargement, fine reticular shadow, interlobular septal thickening, ground glass changes and other signs decreased significantly after treatment as compared with that before treatment (all P<0.05). Conclusion: EDCT has certain diagnostic value in differentiating cardiogenic pulmonary edema.