DIAGNOSTICUL PRIN ANGIOTOMOGRAFIE COMPUTERIZATA IN TROMBOEMBOLISMUL PULMONAR

Autor/autori: Mihai BALINT, Rodica AVRAM, Florina PARV, Mariana TUDORAN, Tudor CIOCARLIE, Iulian AVRAM

Rezumat: Obiectiv. Am studiat impactul metodei angio-tomografiei computerizate (ACT) in diagnosticul pozitiv al tromboembolismului pulmonar (TEP) in legatura si cu modificarile variate clinico-electrocardiografice asociate TEP la internarea pacientului in spital. Metodologie. Am selectat din cazuistica proprie retrospectiv pe o perioada de doi ani, un numar de 38 de pacienti fara istoric de patologie cardiovasculara sau respiratorie si am cercetat datele clinice, anomaliile electrocardiografice in raport cu indexul angiographic CT (I-ACT). Rezultate. Lotul de pacienti a cuprins 20 de femei si 18 barbati, cu varsta medie de 59,6±13,31 ani, din care 55% sub 60 de ani. Manifestarile clinice cele mai frecvente (dispneea, fatigabilitatea, durerea toracica, tahicardia, tahipneea) s-au corelat cel mai bine cu modificarile ECG sugestive de disfunctie ventriculara dreapta in grupul de pacienti cu I-CT peste 40%.In rest I-ACT a prezentat o corelatie mica fata de elementele patologice clinico-ECG reduse la grupul cu I-ACT sub 40%, dar a constituit investigatia decisiva pentru diagnosticul pozitiv. Concluzii. Angio-CT toracic este metoda minim invaziva cea mai fiabila pentru diagnosticul pozitiv al TEP non-masiv, iar indexul angiographic CT se coreleaza cel mai bine cu modificarile clinico-ECG in TEP masiv.

Cuvinte cheie: tromboembolism pulmonar, angio-tomografie computerizata, index angiographic CT.


Abstract: Objective. We studied the contribution of thoracic computed tomography angiography (CT-A) in pulmonary thromboembolism (PTE) positive diagnosis, also connected to varied PTE associated clinical and electrocardiographical changes at hospital admission. Methodology. We retrospectively selected from our casuistry for two years a number of 38 patients without history of cardiovascular or respiratory disease and followed recorded clinical data, ECG abnormalities in relation to CT-A index. Results. The studied patients batch included 20 females and 18 men, mean age of 59,6±13,31 years, from among 55% were under 60 years-old. Most frequent clinical findings (dyspnea, fatigue, chest pain, tachycardia, tachypnea) well correlated to right ventricular dysfunction ECG changes in patients group with CT-A index over 40%, but it was the crucial investigation for positive diagnosis. Conclusion. Thoracic CT-A is thr most reliable low-invasive method for nonmassive PTE positive diagnosis, and CT-A index well correlates to massive PTE clinical and ECG changes

Keywords: pulmonary thromboembolism, thoracic computed tomography angiography, CT angiographic index

 

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