间质性肺疾病对肺动脉高压HRCT征象的影响

http://www.100md.com 2011年7月5日 陈华平 孟志华 杜云 陈振松 石广兴 刘纯钢 方先来 史洪平

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     【摘要】 目的 探讨右肺上叶尖段支气管/伴行动脉直径之比值、主肺动脉直径及右下肺动脉直径对间质性肺疾病相关性肺动脉高压的诊断价值。方法 超声心动图测量临床和HRCT诊断为间质性肺疾病的53例患者的肺动脉收缩压，在HRCT扫描预定层面测量右肺上叶尖段支气管与伴行动脉、主肺动脉及右下肺动脉直径，并记录间质性肺疾病病灶累及范围。分析右肺上叶尖段支气管/伴行动脉之比值、主肺动脉及右下肺动脉直径与肺动脉收缩压的相关性，以及主肺动脉直径与病灶范围之间的相关性。结果 右肺上叶尖段支气管/伴行动脉直径之比值与肺动脉收缩压呈明显相关性(r=0.67，P<0.005)，主肺动脉及右下肺动脉直径与肺动脉收缩压没有明显相关性(r=0.24；P=0.23和r=0.22；P=0.27)。肺动脉收缩压与间质性肺疾病范围无关(r2=0.09，P=0.49)。结论 在间质性肺疾病患者中，右肺上叶尖段支气管/伴行动脉直径之比值是肺动脉高压的可靠指标，而主肺动脉扩张并非是肺动脉高压的可靠指标，主肺动脉扩张可以不表现为肺动脉高压。

    【关键词】 间质性肺疾病;肺动脉高压;高分辨CT

    Effect of interstitial lung diseases on HRCT signs of Pulmonary Hypertension

    CHEN Hua-ping, MENG Zhi-hua, DU Yun,et al.Department of Radiology， The Affiliated Yuebei Peoples Hospital of Shantou University Medical College， Shaoguan 512026, China

    【Abstract】 Objective

    To evaluate the value of the ratio of apical segmental bronchus diameter in superior lobe of right lung to their accompanying pulmonary artery diameters, main pulmonary artery diameter(dPA)and dPA of lower right lung during the diagnose of the Interstitial lung diseases(ILD). Methods Fifty-three patients with ILD clinically proved and confirmed by high resolution computed tomography(HRCT)were studied. Pulmonary artery systolic pressure(PASP)were determined by ultrasoundcardiogram,apical segmental bronchus diameter in superior lobe of right lung and their companying pulmonary artery, main PA diameter(dPA)and dPA of lower right lung were measured by using HRCT, and the extent of ILD was recorded by HRCT as well. The ratio of apical segmental bronchus diameter in superior lobe of right lung to their accompanying pulmonary artery diameters, main pulmonary artery diameter(dPA)and dPA of lower right lung were correlated with PASP.The correlations of main pulmonary artery diameter(dPA)with the extent of ILD were also analyzed. Results There were strong correlations between the ratio of apical segmental bronchus diameter in superior lobe of right lung to their accompanying pulmonary artery diameters and PASP(r=0.67，P<0.005)，while，there were no significant correlations between main pulmonary artery diameter(dPA)and dPA of lower right lung with PASP((r=0 ......

    http://www.100md.com/html/paper/1673-7555/2011/19/05.htm

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