Study of Pulmonary CTPA Combined with D-dimer in the Diagnosis of Emergency Pulmonary Embolism

doi:10.7517/issn.1674-0475.210514

Abstract

Abstract: The purpose of this study was to investigate the value of CT pulmonary angiography (CTPA) combined with D-dimer in the diagnosis of emergency pulmonary embolism. 108 patients with suspected pulmonary embolism were selected, the CTPA and D-dimer were examined, the level of serum D-dimer in patients with pulmonary embolism was significantly higher than that in patients without pulmonary embolism (P<0.05). The area under the ROC curve of D-dimer in predicting pulmonary embolism was 0.921 (P<0.05). The detection rate of CTPA pulmonary embolism in patients with D-dimer ≥ 2.50 μg/mL was significantly higher than that in patients with D-dimer < 2.50 μg/mL (P<0.05). In the indirect signs of CPTA, the proportion of irregular consolidation, atelectasis and inferior vena cava reflux of pulmonary embolism patients were higher than those of non pulmonary embolism patients (P<0.05), D-dimer was positively correlated with CT pulmonary embolism index (CTI%) (r=0.684, P<0.05). CTPA combined with D-dimer detection has good application value in the diagnosis of emergency pulmonary embolism, especially in patients with D-dimer level ≥ 2.50 μg/mL, the detection rate of CTPA pulmonary embolism is high.

Key words: CT pulmonary angiography, D-dimer, emergency pulmonary embolism, diagnostic value

LI Yong, ZHOU Yi, YANG Dichun, DUAN Longyu. Study of Pulmonary CTPA Combined with D-dimer in the Diagnosis of Emergency Pulmonary Embolism[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1221-1225.

References

[1] 张盛斌, 张淇钏, 林茂煌, 等. Wells评分联合年龄校正D-二聚体对住院患者急性肺栓塞的诊断价值[J]. 国际呼吸杂志, 2020, 40(1):25-29.
[2] Alkhatip A, Donnelly M, Snyman L, et al. YEARS algorithm versus Wells' score:Predictive accuracies in pulmonary embolism based on the gold standard CT pulmonary angiography[J]. Critical Care Medicine, 2020, 48(5):1.
[3] 李文玲, 王占鳌, 田兴仓, 等. 探讨Wells评分、Geneva评分及改良Geneva评分应用于国内肺血栓栓塞症患者的诊断价值[J]. 中国现代医学杂志, 2015, 25(17):51-55.
[4] 张凡涛, 罗涛. 中高危急性肺血栓栓塞症患者CTPA检查中Qanadli指数的预后意义[J]. 放射学实践, 2020, 35(12):1537-1541.
[5] 姚仲欣, 解宝泉, 张静华. 64排与256排螺旋CT肺动脉造影诊断老年肺栓塞的对比[J]. 中国临床研究, 2019, 32(3):361-363.
[6] Li H, Chan Y, Li N, et al. Prevalence and predictor of pulmonary embolism in a cohort of Chinese patients with acute proximal deep vein thrombosis[J]. Annals of Vascular Surgery, 2020, 63(13):293-297.
[7] 耿会霞, 张万春, 安彩霞, 等. 肺通气灌注联合肺灌注融合断层显像与CT肺动脉造影对肺栓塞诊断价值的比较[J]. 中国医师杂志, 2019, 21(7):1020-1023, 1029.
[8] Mueller-Peltzer K, Krauss T, Benndorf M, et al. Pulmonary artery thrombi are co-located with opacifications in SARS-CoV2 induced ARDS[J]. Respiratory Medicine, 2020, 172(14):106135.
[9] 白洪忠, 刘宁, 纪俊雨, 等. 多层螺旋CT肺动脉造影扫描在肺栓塞诊断及病情严重程度评价的价值[J]. 中国医学装备, 2019, 16(5):36-39.
[10] Isaacs D J, Johnson E J, Hofmann E R, et al. Primary care physicians comprehensively manage acute pulmonary embolism without higher-level-of-care transfer:A report of two cases[J]. Medicine, 2020, 99(45):e23031.
[11] 蒲先智, 胡鑫, 戴贵东, 等. CT肺动脉造影定量参数评估中心肺栓塞患者右心功能及预后[J]. 中国介入影像与治疗学, 2020, 17(6):369-373.
[12] 火忠, 王英颖, 巴图尔·吐尔地. 肺癌合并肺栓塞CT肺动脉造影表现、凝血及纤溶指标分析[J]. 实用放射学杂志, 2020, 36(4):563-566.
[13] Fang C, Pan H, Li Z B, et al. Invasive thymoma leading to pulmonary artery embolism during operation:A case report[J]. Medicine, 2019, 98(28):16385.
[14] 彭寸敬, 丁红艳, 王亚飞, 等. 血浆D-二聚体、B型脑钠肽联合Wells评分对肺栓塞的诊断价值[J]. 岭南心血管病杂志, 2019, 25(1):96-100.
[15] 马青松, 张静, 罗露露, 等. 128层螺旋CT肺动脉造影对急性肺栓塞患者栓塞程度和右心功能的评估价值研究[J]. 现代生物医学进展, 2019, 19(9):1731-1734, 1757.
[16] 于养生, 贺光磊, 刘现亮, 等. 肝细胞生长因子联合D-二聚体及Wells评分在急性肺栓塞患者诊断中的应用价值[J]. 临床肺科杂志, 2020, 25(5):675-679.
[17] 周怀海, 秦志强, 覃少佳, 等. 肺栓塞患者炎症指标与CT肺动脉阻塞指数的关系[J]. 国际呼吸杂志, 2020, 13(1):19-24.
[18] 黄隽敏, 庄须翠, 王真. D-二聚体年龄校正阈值在老年肺栓塞排除诊断中的意义与价值[J]. 临床急诊杂志, 2019, 20(2):93-96.