ABSTRACT
Objective:To investigate the value of pulmonary perfusion defect index (PPDI), pulmonary artery obstruction index (PAOI) and right heart function parameters in the evaluation of severity of pulmonary embolism.Methods:The clinical data of 108 patients with pulmonary embolism who received treatment in The Second Hospital of Jiaxing from January 2019 to June 2021 were retrospectively analyzed. These patients were divided into high-risk ( n = 25), moderate-risk ( n = 32), and low-risk ( n = 51) groups according to the severity of pulmonary embolism. PAOI, PPDI, right ventricular short axis maximum diameter (RV), left ventricular short axis maximum diameter (LV), ratio of right/left right ventricular short axis maximum diameter (RV/LV) were determined in each group. PPDI, PAOI and right ventricular function parameters were correlated with the severity of pulmonary embolism. The area under the receiver operating characteristic curve, specificity and severity of PPDI, PAOI, RV, LV, RV/LV used alone and in combination to predict the severity of pulmonary embolism were analyzed. Results:PPDI, PAOI, RV, and RV/LV in the high-risk group were (32.52 ± 10.85)%, (45.01 ± 15.02)%, (50.32 ± 12.32) mm, (1.42 ± 0.45), respectively, which were significantly lower than (5.32 ± 1.85)%, (12.52 ± 3.25)%, (37.25 ± 8.52) mm, (0.96 ± 0.21) in the low-risk group, and LV was significantly lower in the high-risk group than that in the low-risk group [(35.14 ± 10.52) mm vs. (44.02 ± 15.21) mm, t = 13.95, 11.91, 2.62, 6.09, 5.44, all P < 0.05]. PPDI, PAOI, RV, and RV/LV in the moderate-risk group were (18.62 ± 6.02)%, (28.65 ± 8.65)%, (45.85 ± 10.02) mm, and (1.20 ± 0.32), respectively, which were significantly higher than those in the low-risk group ( t = 14.75, 12.06, 4.18, 4.13, all P < 0.05). There was no significant difference in LV between moderate-risk and low-risk groups ( t = 1.51, P > 0.05). Spearman correlation analysis showed that PPDI, PAOI, RV, RV/LV were positively correlated with the severity of pulmonary embolism ( r = 0.87, 0.84, 0.45, 0.41, all P < 0.001). LV was negatively correlated with the severity of pulmonary embolism ( r = -0.27, P < 0.001). The receiver operating characteristic curve (ROC curve) showed that the areas under the receiver operating characteristic curve of PPDI, PAOI, RV, LV, RV/LV used alone or in combination to predict the severity of pulmonary embolism were 0.941, 0.911, 0.721, 0.693, 0.726, and 0.951, respectively (all P < 0.001). Conclusion:PPDI, PAOI and right heart function parameters can be used as effective indexes to dynamically monitor the severity of pulmonary embolism.
ABSTRACT
OBJETIVOS: Correlacionar os achados da biópsia transcutânea hepática guiada por ultrassonografia com os dados ultrassonográficos modo B e Doppler da veia hepática direita; comparar os padrões de onda entre os grupos de estudo (hepatopatas) e controle (sadios); e avaliar se o Doppler da veia hepática direita serve como marcador de hepatopatia crônica. MÉTODOS: Foram estudados 38 pacientes portadores de hepatopatia crônica comprovada por sorologia e biópsia (grupo de estudo) e dez pacientes sem hepatopatia sorológica (grupo controle), avaliados pela ultrassonografia modo B e Doppler. Os critérios histológicos foram a classificação da Sociedade Brasileira de Patologia de Hepatite Crônica. RESULTADOS: A ultrassonografia modo B e o Doppler diferenciaram os indivíduos portadores de hepatopatia crônica dos normais (p=0,047). Houve diferença significativa entre o grupo de estudo e o controle na comparação entre os achados histopatológicos, ultrassonográficos modo B e o Doppler nos padrões de onda da veia hepática direita (p=0,001). CONCLUSÃO: Foi possível correlacionar a biópsia hepática com a ultrassonografia modo B e o Doppler da veia hepática direita; os hepatopatas apresentaram alteração no fluxo da veia hepática direita e os normais não, sendo que o padrão de onda nos controles saudáveis foi trifásico e nos hepatopatas bifásico ou monofásico; e o Doppler da veia hepática direita serviu como marcador de hepatopatia crônica.
OBJECTIVE: To correlate chronic liver disease diagnosed by transcutaneous liver biopsy guided by ultrasound, with ultrasound findings with B-mode and Doppler of the right hepatic vein; 2) to compare the wave patterns between the study group and the control group; 3) to compare the right hepatic vein Doppler findings with histopathology findings as a possible marker of chronic liver disease. METHODS: Were studied 38 patients with chronic liver disease diagnosed by biopsy and serology (study group) and 10 persons without serologic liver disease (control group), assessed only by ultrasound B-mode and Doppler. The criteria were based on histology classification of the Brazilian Society of Pathology for chronic hepatitis. Chi-square, Fisher's exact and Student t tests were used. RESULTS: The B-mode and Doppler ultrasound were useful in inferring the differentiation between individuals with chronic liver disease from normal. There were significant differences between the study group and the controls when comparing the histopathology findings, ultrasound B-mode and Doppler in relationship to the wave patterns of the right hepatic vein. CONCLUSION: The correlation of liver biopsies with ultrasound B-mode and Doppler of hepatic vein was positive; 2) individuals with liver disease showed alterations in the flow of the right hepatic vein and normal subjects not, being the wave pattern in normal triphasic and in patients with chronic liver disease monophasic or biphasic; 3) Doppler of the right hepatic vein is useful marker for chronic liver disease.