CTA在急性复杂性大咯血患者行介入栓塞术前的应用价值分析

doi:10.7517/issn.1674-0475.190803

影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (1): 109-115.DOI: 10.7517/issn.1674-0475.190803

CTA在急性复杂性大咯血患者行介入栓塞术前的应用价值分析

陈庭宇¹, 龚齐云², 邓旭东¹, 王恒¹, 任杨¹, 袁元¹

1. 四川大学华西医院放射科, 四川成都 610041;
2. 成都市第五人民医院放射科, 四川成都 610041

收稿日期:2019-07-28 出版日期:2020-01-15 发布日期:2020-01-15

Application Value of CTA in Patients with Acute Complicated Massive Hemoptysis before Interventional Embolization

CHEN Tingyu¹, GONG Qiyun², DENG Xudong¹, WANG Heng¹, REN Yang¹, YUAN Yuan¹

1. Radiology Department, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, P. R. China;
2. Radiology Department, Chengdu Fifth People's Hospital, Chengdu 610041, Sichuan, P. R. China

Received:2019-07-28 Online:2020-01-15 Published:2020-01-15

摘要/Abstract

摘要： 本文探讨了CT血管造影（CT angiography，CTA）在急性复杂性大咯血患者行介入栓塞术前的应用价值。回顾性选择49例急性复杂性大咯血患者CTA影像资料，通过与术中数字减影血管造影（digital subtraction angiography，DSA）结果进行对比，发现CTA对罪犯血管诊断准确率为89.33%，对多动脉交通吻合诊断准确率为86.96%。Kappa检验CTA与DSA检查结果一致性较高，受试者特征曲线（ROC）分析CTA诊断急性复杂性大咯血罪犯血管的曲线下面积（AUC）为0.947（95%CI：0.903~0.990，P=0.000），灵敏度89.33%，特异度100.00%。通过随访发现CTA指导下行介入栓塞术治疗有效率91.84%，术后1年无大咯血复发病例。

关键词: CTA, 大咯血, 罪犯血管, 介入栓塞术

Abstract: To evaluate the value of CT angiography (CTA) before interventional embolization in patients with acute complex massive hemoptysis, CTA imaging data of 49 patients with acute complex massive hemoptysis were selected retrospectively. Compared with intraoperative digital subtraction 109 angiography (DSA), it was found that the accuracy rate of vascular diagnosis for criminals was 89.33%,and 86.96% for multi-artery anastomosis. The results of CTA and DSA by Kappa test were in good agreement. Receiver operating characteristic curve (ROC) analysis showed that the area under curve (AUC) of CTA in the diagnosis of acute complicated massive hemorrhage criminals was 0.947 (95%CI:0.903~0.990, P=0.000),with sensitivity 89.33% and specificity 100.00%. Follow-up showed that the effective rate of interventional embolization guided by CTA was 91.84%. There was no recurrence of massive hemoptysis in one year after operation.

Key words: CTA, massive hemoptysis, criminal vessels, interventional embolization

陈庭宇, 龚齐云, 邓旭东, 王恒, 任杨, 袁元. CTA在急性复杂性大咯血患者行介入栓塞术前的应用价值分析[J]. 影像科学与光化学, 2020, 38(1): 109-115.

CHEN Tingyu, GONG Qiyun, DENG Xudong, WANG Heng, REN Yang, YUAN Yuan. Application Value of CTA in Patients with Acute Complicated Massive Hemoptysis before Interventional Embolization[J]. Imaging Science and Photochemistry, 2020, 38(1): 109-115.

参考文献

[1] Ittrich H, Bockhorn M, Klose H, et al. The diagnosis and treatment of hemoptysis[J]. Deutsches Arzteblatt International, 2017, 114(21):371-381.
[2] Miyano Y, Kanzaki M, Onuki T. Bronchial artery embolization:first-line option for managing massive hemoptysis[J]. Asian Cardiovascular Thoracic Annals, 2017, 25(9):618-622.
[3] 樊庆胜, 陈信义. 支气管动脉及其他体循环动脉参与复杂性大咯血的介入治疗[J]. 山西医药杂志, 2014, 43(12):1359-1361. Fan Q S, Chen X Y. Transcatheter arterial embolization of bronchial artery and artery of systemic circulation supply to the lung for massive intractable hemoptysis[J]. Shanxi Medical Journal, 2014, 43(12):1359-1361.
[4] Lorenz J, Sheth D, PateI J. Bronchial artery embolization[J]. Seminars in Interventional Radiology, 2012, 29(3):155-160.
[5] 张媛, 刘浩. CTA对下肢动脉硬化闭塞症支架内再狭窄的评估价值[J]. 中国CT与MRI杂志, 2017, 15(12):127-129. Zhang Y, Liu H. Value of CTA in the evaluation of in stent restenosis in patients with lower extremity arteriosclerosis obliterans[J]. Chinese Journal of CT and MRI, 2017, 15(12):127-129.
[6] Noe G D, Jaffe S M, Molan M P. CT and CT angiography in massive haemoptysis with emphasis on pre-embolization assessment[J]. Clinical Radiology, 2011, 66(9):869-875.
[7] 王彬, 闵旭红, 苏攀, 等. 术前CTA在支气管扩张大咯血介入治疗中的应用[J]. 中国医学计算机成像杂志, 2017, 23(2):131-135. Wang B, Min X H, Su P, et al. Clinical value of bronchial artery CT angiography in patients with bronchiectasis[J]. Chinese Computed Medical Imaging, 2017, 23(2):131-135.
[8] 中国医师协会整合医学分会呼吸专业委员会. 大咯血诊疗规范[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(1):1-8. Respiratory Committee of Integrated Medical Association of Chinese Medical Association. Standard for diagnosis and treatment of massive hemoptysis[J/CD]. Chinese Journal of Lung Disease(Electronic Edition), 2019, 12(1):1-8.
[9] Cody O'Dell M, Gill A E, Hawkins C M. Bronchial artery embolization for the treatment of acute hemoptysis[J]. Techniques in Vascular and Interventional Radiology, 2017, 20(4):263-265.
[10] Ittrich H, Klose H, Adam G. Radiologic management of haemoptysis:diagnostic and interventional bronchial arte-rial embolization[J]. RoFo, 2015, 187(4):248-259.
[11] Fujii H, Fujita A, Nakamura H, et al. Endovascular embolization of an aberrant bronchial artery originating from the internal mammary artery in a patient with hemoptysis[J]. Radiollogy Case Reports, 2016, 2016:2707195.
[12] Kai N, Oda S, Utsunomiya D, et al. Dual-region-of-interest bolus-tracking technique for coronary computed tomographic angiography on a 320-row scanner:reduction in the interpatient variability of arterial contrast enhancement[J]. British Journal of Radiology, 2018, 91(1081):20170541.
[13] 董红建. 非肿瘤性大咯血介入栓塞术治疗后复发原因分析[J]. 现代仪器与医疗, 2018, 24(6):44-46. Dong H J. Reasons for recurrence of non-neoplastic massive hemoptysis after interventional embolization[J]. Modern Instruments & Mediccal Treatment, 2018, 24(6):44-46.
[14] Shimohira M, Ohta K, Nagai K, et al. Bronchial arterial embolization using a gelatin sponge for hemoptysis from pulmonary aspergilloma:comparison with other pulmonary diseases[J]. Emergency Radiology, 2019, 26(5):501-506.

CTA在急性复杂性大咯血患者行介入栓塞术前的应用价值分析

Application Value of CTA in Patients with Acute Complicated Massive Hemoptysis before Interventional Embolization

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

编辑推荐

Metrics

本文评价