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目的探讨急慢性期下肢深静脉血栓形成(DVT)的多层螺旋CT(MSCT)征象与凝血纤溶指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)之间的相关性。资料与方法回顾性分析37例DVT患者资料,根据病程将DVT分为急慢性期,观察MSCT增强图像上血栓及软组织表现,测量平扫时轴位图像上血栓CT值。根据MSCT上血栓形态、血栓分布范围、CT值分组,分析MSCT征象与PT、APTT、FIB、TT的相关性。结果根据病程分组,急性期DVT 18例,MSCT主要表现为管腔中央充盈缺损,管腔扩大,血栓呈连续性分布,软组织肿胀;慢性期DVT 19例,MSCT主要表现为管腔内偏心性充盈缺损,血栓分布呈节段性,侧支循环增多、浅静脉迂曲;平扫时急慢性期血栓CT值平均数分别为(59.26±11.89)HU和(37.42±9.46)HU,U=20.92,P<0.05,差异有统计学意义。MSCT上,血栓形态为中心性充盈缺损组PT、APTT、FIB值均较偏心性充盈缺损组高,t值分别为4.95、3.27、4.05,P<0.05;血栓呈连续性分布组PT值较节段性分布组高,t=6.10,P<0.05;血栓CT值≥53.6 HU组PT、APTT、FIB值均较CT值<53.6 HU者高,t分别为3.97、6.21、6.14,P<0.05,差异存在统计学意义。结论急慢性期DVT的MSCT表现与PT、APTT、FIB存在一定相关性,TT未见明显相关性,结合两者检查,可提高血栓急慢性期判断的准确性,为临床治疗方案的制定提供可靠依据。
Objective To investigate the correlation between multi-slice spiral CT (MSCT) features and coagulation and fibrinolysis indexes of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) ), Thrombin time (TT) between the correlation. Materials and Methods Retrospective analysis of 37 cases of DVT patients, according to the duration of DVT will be divided into acute and chronic phase, MSCT to enhance the performance of thrombus and soft tissue imaging, CT images of axial images were measured. The correlation between MSCT features and PT, APTT, FIB and TT was analyzed according to the thrombus morphology, thrombus distribution and CT value of MSCT. Results According to the course of disease, 18 cases were diagnosed as acute DVT. The main manifestations of MSCT were central filling defect, enlarged lumen, continuous distribution of thrombus and swollen soft tissue. In chronic phase, DVT was found in 19 cases. MSCT mainly showed intraluminal eccentric filling The average CT value of acute and chronic thrombus during plain scan were (59.26 ± 11.89) HU and (37.42 ± 9.46) HU, respectively, U = 20.92, P <0.05, the difference was statistically significant. MSCT, thrombosis central filling defect group PT, APTT, FIB values were higher than the eccentric filling defect group, t values were 4.95,3.27,4.05, P <0.05; thrombosis was continuous distribution group PT value section The values of PT, APTT and FIB in HU group were higher than those in CT group <53.6 HU, t = 3.97, 6.21, 6.14, P <0.05, The difference is statistically significant. Conclusion MSCT of acute and chronic DVT has a certain correlation with PT, APTT and FIB, and TT has no obvious correlation. Combined with the two tests, it can improve the accuracy of judgment of acute and chronic thromboembolism and provide a reliable basis for the development of clinical treatment plan in accordance with.