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 pulmonarangio-tomografie computerizataindex 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 thromboembolismthoracic computed tomography angiographyCT angiographic index
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