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目的探讨急性肺动脉血栓栓塞(PTE)患者病情变化对CT肺动脉造影(CTPA)与数字减影血管造影(DSA)诊断一致性的影响及其机制。方法搜集行介入手术治疗且术前及术后均行CTPA检查的PTE患者29例。以DSA为标准评价CTPA对PTE的诊断能力。结果 29例PTE患者的同期CTPA与DSA评分差异无统计学意义;21例次出现评分差异的DSA评分值明显高于37例次评分一致病例,且主要集中分布在评分≥9分的区间。结论 PTE患者病情的不断急剧变化可能是导致CTPA与DSA检查影像差异且不可避免的重要因素,在排除影响CTPA图像质量可能因素的情况下,CTPA与DSA检查影像差异可能是PTE病程中不同时间窗内病情变化的影像学表现,不应该被完全认定为漏诊或误诊。
Objective To investigate the effect of changes in patients with acute pulmonary thromboembolism (PTE) on the diagnostic consistency between CT pulmonary angiography (CTPA) and digital subtraction angiography (DSA). Methods Twenty-nine patients with PTE who underwent CTPA before and after PCI were recruited. Evaluate CTPA diagnostic ability of PTE with DSA as the standard. Results There was no significant difference in CTPA and DSA scores between the two groups in 29 PTE patients. The DSA scores of 21 patients with different grades were significantly higher than those of 37 patients with the same score, and were mainly concentrated in the range of ≥9. Conclusion The continuous and drastic changes of PTE patients’ condition may be the important and inevitable factors that lead to the difference between CTPA and DSA images. In excluding the possible factors affecting CTPA image quality, the differences between CTPA and DSA images may be different time windows Imaging findings of changes in the condition should not be completely misdiagnosed as missed or misdiagnosed.