目的 采用多层螺旋CT肺动脉造 影(MSCTPA)评价急性肺栓塞与右心功能 参数的相关性，评估急性肺栓塞患者的 严重程度。方法 采用非心电门控技术回 顾性分析2012年1月-2013年11月间行多层 螺旋CT肺动脉造影患者107例，其中肺栓 塞组患者57例，对照组50例。采用CT后处 理软件测量主肺动脉及胸主动脉内径比值 (PA/AO)、右心室相关参数包括四腔心层 面左右室短轴内径比(RVD/LVD)及截面积 比(RVA/LVA)、横断面左右心室最大短轴 内径比值(RV/LV-LD)。对中心死亡、中 心存活、周围型肺栓塞及对照组之间右 心功能各组参数进行比较。结果 肺栓塞 组右心室相关参数RVD/LVD、RV/LV-LD、 RVA/LVA均明显大于对照组(P<0.05)；而 PA/AO于两组间无明显差异。肺栓塞组中 中心死亡组与中心存活、周围、对照组的 RVD/LVD、RV/LV-LD及RVA/LVA三项指标均 存在统计学差异(P=0.000)；中心存活与 周围组的RVD/LVD、RVA/LVA两参数间有差 异(P<0.05)；而周围组与对照组的以上三 项指标间均无明显差异(P>0.05)。对中心 死亡组右心计量指标进行ROC曲线分析得 出，RVA/LVA预测APE早期死亡准确性最佳 (AUC=0.873)，敏感性为100%，特异度为 71.2%。结论 多层螺旋CT肺动脉成像不仅 能够准确诊断急性肺栓塞，还能客观评价 右心室各相关参数，对评估肺动脉栓塞严 重程度具有重要意义。

Objective To evaluate the correlation between acute pulmonary embolism(PE) and right cardiac function by multi-slice Spiral CT pulmonary angiography (MSCTPA), and assess the severity of patients with acute pulmonary embolism. Methods A retrospective study including 107 cases MSCTPA data, of which 57 cases with PE, 50 cases without pulmonary embolism, from January 2012 to November 2013. Using CT postprocessing software measured thoracic aorta and main pulmonary artery inner diameter ratio (PA/AO), right ventricular correlation parameter, including right ventricle diameter to left ventricle diameter ratio (RVD/LVD) and right ventricle area to left ventricle area ratio (RVA/LVA) on axial four-chamber (4-CH) sections and the largest of maximum minor axis diameters on axial sections (RV/LV-LD). To compare the difference of CT related right heart parameter between the groups of central PE with death,central PE survivor, peripheral PE and the control group. Results There were significantly different between PE group and the control group with CT-related right ventricular parameters RVD/LVD,RV/LV-LD,RVA/LVA in PE group(P<0.05) (excepting PA/AO). Statistically significant differences were found in these measurements (RVD/LVD,RV/LV-LD,RVA/LVA)comparing patients with central PE with death and central PE survivors and those with peripheral PE and control group(P=0.000). There were significantly different between central PE survivor and peripheral PE with CTrelated right ventricular parameters RVD/LVD, RVA/LVA, but there were no statistically significant differences between peripheral PE patients and the control group in all RV parameters. Analyze the cor dextrum measuring index ROC curve of central PE with death group, RVA/LVA is the best indicator of predicting early death (AUC=0.873), with a sensitivity of 100%,specificity71.2%. Conclusion MSCTPA not only is able to accurately diagnose acute pulmonary embolism, but also is an objective evaluation of all relevant parameters of the right ventricle. Which plays an important role in assessing the severity degree of acute pulmonary embolism.