The CT Evaluation Of Right Ventricular Function In Patients With Pulmonary Embolism

Objective：Slice spiral CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism (PE) induced right ventricular dysfunction (RVD) incomplete clinical effects of the disease, improve the diagnostic accuracy of these patients, so that patients receive timely treatment, improve patient survival.Methods：This report collects60patients who were diagnosed with pulmonary embolism by CTPA and given UCG examined,and all of them from the First Affiliated Hospital of Henan University of Science and Technology during2011~2013. On the standard of the UCG test results on right ventricular function, patients were divided into two group,one was “right ventricular dysfunction group (24cases)”,another was “non-right ventricular dysfunction group (36cases)”, On the base of collate and statistics data in clinical symptoms, signs and base diseases,analysis its correlation with pulmonary embolism. The CTPA reflects nine quantitative indicators of cardiac function while the UCG reflects three qualitative indicators, statistic the results of two groups, but we treat UCG diagnosis as the "gold standard", to diagnosis sensitivity and specificity of the of right ventricular function by calculating CTPA, Kappa value was used to observed the consistency in both,and it would be meaningful if the Kappa values above0.7.Results：General information, among this two groups, it had no statistically significant difference in age, sex ratio (P>0.05). In the symptoms we analysis,8cases in the24cases of RVD patients appeared syncope, while that were3cases in another group, there was a significant difference (P<0.05). In the underlying disease, the RVD patients group include7patients with a history of right heart thrombus,11cases with hypertension,7cases with coronary heart disease,6cases with malignancy,8cases a history with thrombophlebitis,15cases with deep vein thrombosis history; Non-RVD group of patients were0cases,3cases,1case,1case,1case,9cases; there were significant differences (P<0.05). In signs,8cases appeared cyanosis in RVD patients group,12cases appeared lung moist rales, while in non-RVD patients the numbers were3cases,6cases, there was a significant difference (P<0.05). On the gold standard–the UCG results, the thickness for CTPA in measured maximum short axis diameter of the left and right ventricle and interventricular septum both were95.5%, while the sensitivity both were92.1%, and the Kappa value got0.80; in the same time, for the largest area of the right ventricular,sensitivity is90.9%specificity is89.5%, Kappa value is0.79; for the diameter of the main pulmonary artery and right pulmonary artery diameter,both sensitivity and specificity were90.0%, Kappa value is0.70; the sensitivity and specificity of vena cava were93.3%, while Kappa value is0.83;for Right ventricular wall, thickness sensitivity is88.9%, specificity is90.5%, Kappa value is0.70; azygos vein diameter sensitivity is88.2%, specificity is90.7%, Kappa value is0.76; left ventricular septal sudden rate sensitivity is90.6%, specificity is96.4%, Kappa value is0.93; IVC reflux rate sensitivity is72.7%, specificity is97.4%, Kappa value is0.77; azygos vein reflux rate sensitivity is73.7%, specificity is97.6%, Kappa value is0.79. All above were in highly consistent.Conclusion：Using CTPA to check out the patients got pulmonary embolism,who also had got a based disease-right ventricular dysfunction,from which we can got a satisfactory diagnostic accuracy, finally complete the diagnosis of pulmonary embolism patients by "One-stop", save time, reduce the financial burden of patients, clinicians could be diagnose the patient’s condition in a timely manner, and then provide effective treatment to reduce the mortality and improve the quality of life and safety of patients, worthy of clinical application.