非对比CT示鞍状肺栓塞

B. Chaudhry, K. Alekseyev, L. Didenko, Gennadiy Ryklin, David Lee
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摘要

背景:鞍状肺栓塞(PE)是一种跨越肺干分叉的大栓塞。PE延伸至左、右肺动脉。男性的发病率更高。PE的常见特征包括呼吸困难、呼吸急促、咳嗽、咯血、胸膜炎性胸痛、心动过速、低血压、颈静脉扩张,严重者可出现Kussmaul征。预试概率采用了威尔斯PE准则。诊断包括d -二聚体水平、CT肺血管造影(CTPA)、通气/灌注显像(V/Q扫描)、超声心动图、下肢静脉超声、胸部x线、肺血管造影和心电图(ECG)。病例描述:我们报告一名65岁男性,有两周的呼吸困难病史,伴有非辐射性间歇性胸压。最初的V/Q扫描显示PE的可能性很低,但随后的非对比CT显示他确实有鞍状PE。
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Saddle pulmonary embolism on non-contrast CT
Background: A saddle pulmonary embolism (PE) is a large embolism that straddles the bifurcation of the pulmonary trunk. This PE extends into the right and left pulmonary arteries. There is a greater incidence in males. Common features of a PE include dyspnea, tachypnea, cough, hemoptysis, pleuritic chest pain, tachycardia, hypotension, jugular venous distension, and severe cases Kussmaul sign. The Wells criteria for PE is used as the pretest probability. Diagnostics include D-dimer levels, CT pulmonary angiography (CTPA), ventilation/perfusion scintigraphy (V/Q scan), echocardiography, lower extremity venous ultrasound, chest x-ray, pulmonary angiography, and electrocardiography (ECG). Case description: We present a 65-year-old male that presented with a two-week history of dyspnea with non-radiating intermittent chest pressure. Initial V/Q scan showed a low probability for PE, but a subsequent non-contrast CT revealed that he indeed had a saddle PE.
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