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胸部コンピュータトモグラフィーの右心室拡大:急性肺栓塞における予後的役割
Rene Quiroz1, Nils Kucher, U Joseph Schoepf
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.
Circulation
|May 19, 2004
まとめ
CT4室画像の右心房の拡大は,急性肺栓塞 (PE) 患者における有害事象を予測する. この方法は,高リスクの個人を特定するために,軸の視点よりも優れています.
科学分野:
- 放射線学 放射線学
- 心臓病学 心臓病学
- 肺医学 肺医学について
背景:
- 急性肺栓塞 (PE) は,罹病率と死亡率の重要な原因です.
- 急性PEの予測指標は,リスクの階層化と管理に不可欠です.
- 右心室の膨張は,急性PEの既知の合併症である.
研究 の 目的:
- 急性PEにおける多検出器列胸部CTにおける右心房拡張の予後的役割を調査する.
- 右心室の膨張を評価するために,異なるCTビューの精度を比較する.
- 急性PEの高リスク患者を特定し,より密接なモニタリングまたは積極的な治療から利益を得ることができる.
主な方法:
- CT検査で確定したPEを患った63人の患者を研究した.
- エコーカルディオグラフィはCTスキャンから24時間以内に実施した.
- 右心室と左心室の寸法 (RV(D,LV(D)) のオフラインCT測定は,軸面と再構築された4室 (4-CH) ビューを使用して行われました.
主要な成果:
- RV(D) /LV(D)>0.9の4CHの見方は,有害事象 (80.3%) を有する患者よりも (51.3%;P=0.015) を有しない患者でより一般的でした.
- 有害事象を予測する曲線の下の面積は,4-CHビューでは0.753で,軸のビューでは0.667でした.
- RV(D) /LV(D)>0.9 4-CHの見方では,独立して予見された有害事象 (OR,4.02;P=0.041) が予想されました.
結論:
- 再構築されたCT 4-CHビューの右心房拡大は,急性PE患者の不良臨床イベントを予測します.
- 4CHビューからの静脈CT測定は,高リスク患者を特定するために軸視よりも優れています.
- このイメージングテクニックは,急性PEのリスク分層化を支援し,治療決定を導くことができます.
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