目的 分析肺栓塞伴有右心功能 不全患者CT影像学表现。方法 将我院自 2013年2月-2015年2月经CT肺血管造影 (CTPA)证实为肺栓塞的60例患者作为研究 对象，同时选取同期接受CTPA检查但未合 并肺栓塞的40例患者作为对照组，均接受 CT肺动脉造影检查，并于2d内作超声心动 图检查，分析肺栓塞伴右心功能不全患者 CT诊断价值。结果 研究组右心室最大短 轴直径为(3.65±0.91)cm、最大横截面积 为(18.20±6.12)cm，均明显大于对照组 (P<0.05)；以超声心动图为标准，CTPA检 出右心室扩大敏感度为71.43%，特异度为 89.74%；中央型患者最大横截面积大于周 围型肺栓塞患者(P<0.05)。结论 在肺栓 塞伴右心功能不全患者的临床诊断中，采 用CTPA检查方式，兼具较高的敏感度与特 异性，且可在检出肺栓塞的同时判断患者 有无右心扩大及功能不全表现，可为患者 的临床治疗方案的确立提供指导。

Objective To analyze the CT imaging features of patients with pulmonary embolism accompanied by right ventricular dysfunction. Methods 60 patients with pulmonary embolism confirmed by CT pulmonary angiography (CTPA) admitted into the hospital from February 2013 to February 2015 were selected as the research object. And another 40 patients receiving CTPA examination but not complicated with pulmonary embolism were selected as the control group. Thay all received CT pulmonary angiography and ultrasonic echocardiography with 2d. The the diagnostic value of CT in patients with pulmonary embolism accompanied by right ventricular dysfunction was analyzed. Results The maximum stub axle diameter of right ventricular in the research group was (3.65±0.91) cm and the largest cross-sectional area was (18.20±6.12) cm which were significantly higher than those in the control group (P<0.05). Taking ultrasound echocardiography as the standard, the sensitivity of right ventricle expand detected by CTPA was 71.43% and the specificity was 89.74%, the maximum cross sectional area of the central type patients was larger than that of peripheral type patients with pulmonary embolism (P<0.05). Conclusion In the clinical diagnosis of patients with pulmonary embolism accompanied by right ventricular dysfunction, to adopt CTPA examination is of both high sensitivity and specificity and can detect pulmonary embolism and judge whether patients have right heart enlargement and dysfunction, which can provide guidance for the clinical establishment of treatment regimen for patients.