SPIRAL CT OF BRONCHIAL ARTERIES IN CHRONIC THROMBOEMBOLISM
SPIRAL CT OF BRONCHIAL ARTERIES IN CHRONIC THROMBOEMBOLISM
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DOI：
10.1097/00004728-199411000-00002
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发表时间：
1994-11-01
影响因子：
1.3
通讯作者：
THELEN, M
中科院分区：
文献类型：
--
作者：
KAUCZOR, HU;SCHWICKERT, HC;THELEN, M
目的：对支气管动脉解剖进行计算机断层扫描研究，评估扩张和迂曲作为慢性血栓栓塞患者肺动脉高压和手术风险的指标。材料和方法：我们回顾性评价了 39 例接受肺血栓内膜切除术的患者的增强薄层螺旋 CT 扫描。结果与所有患者的平均肺动脉 (PA) 压力、33 名患者的术后死亡率以及 5 名患者的术后 CT 进行了比较。 20例无肺动脉高压的患者作为对照。结果：肺动脉高压组39例患者中，30例观察到50条支气管动脉。他们的患病率显着高于对照组（p < 0.0001）。 20 名患者（51%）的近端直径测量大于或等于 1.5 毫米； 14 例（36%）发现了曲折的路线。支气管动脉总直径与平均 PA 压力之间的相关性较差 (r = 0.2)。支气管动脉扩张的患者术后死亡风险显着低于无支气管动脉扩张的患者（p < 0.05）；阳性预测值为 100%，置信区间为 0.79-1.0。尽管术后 PA 压力正常，但在后续研究中仍可见支气管动脉。结论：支气管动脉、扩张和迂曲的 CT 表现为慢性血栓栓塞性肺动脉高压提供了指标。其程度无法估计。扩张的支气管动脉是肺血栓内膜切除术存活的重要预测因子。
Objective: Computed tomography study of bronchial artery anatomy and evaluation of dilatation and tortuousity as indicators for pulmonary hypertension and surgical risk in patients with chronic thromboembolism were performed.Materials and Methods: We retrospectively reviewed contrast-enhanced, thin section spiral CT scans of 39 patients undergoing pulmonary thromboendarterectomy. Findings were compared with mean pulmonary artery (PA) pressure in all, postoperative mortality in 33, and postoperative CT in 5 patients. Twenty patients without pulmonary hypertension served as controls.Results: In the pulmonary hypertension group, 50 bronchial arteries were observed in 30 of 39 patients. Their prevalence was significantly higher than in the control group (p < 0.0001). Their proximal diameter measured greater than or equal to 1.5 mm in 20 patients (51%); a tortuous course was found in 14 (36%). The correlation between total bronchial artery diameter and mean PA pressure was poor (r = 0.2). Patients with dilated bronchial arteries had a significantly lower risk for postoperative death than patients without (p < 0.05); positive predictive value was 100% and confidence interval 0.79-1.0. Despite normal postoperative PA pressures, bronchial arteries were still visible on follow-up studies.Conclusion: The CT depiction of bronchial arteries, dilatation, and tortuousity provides indicators for chronic thromboembolic pulmonary hypertension. Its degree cannot be estimated. Dilated bronchial arteries are a significant predictor for survival of pulmonary thromboendarterectomy.