Purpose
The cause of acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) is often difficult to determine.
The prevalence of Pulmonary Embolism (PE) in patients with COPD was 20-25% [1,
2].The factors,
predisposing to the PE in patients with COPD was: the pulmonary heart with the presence of mural blood clots in the right ventricle; the violation of aggregation of platelets,
fibrinolysis,
polycythemia; decreased physical activity; systemic inflammatory reaction the body; smoking [3,4].
The goal of our report to show wide possibility MSCT in diagnosis of...
Methods and Materials
During the 3 years were examined 258 patients with acute exacerbation of COPD (186 man and 72 females).
Pulmonary embolism was found in 46 patients (17,8%).
The examinations were produced on multislice CT Light Speed VCT-64 General Electric and Aquillion-320 Toshiba.
Patients received 80-150 mL of contrast material (iohexol,
iodixanol,
ioversol) an injection rate of 3,5-4,0 ml/sec.
The US-doppler scan,
perfusion scintigraphy,
Ehocardiography and D-dimer were fulfilled also.
Table 1 show the characteristics of the 43 included patients.
Table 1.
Characteristics of the patients.
Characteristics...
Results
Clinical symptoms: expressed shortness of breath (3-4 degree on a scale MRCDS) and chest pain (74,3%).
Blood gas analyses:рН – 7,36±0,9; Ро2 – 46,2±12,1; Рсо2 – 50,1±10,3.
The values of the gas composition of the blood in patients with PE authentically did not differ from those of the other causes of an exacerbation of COPD.
In patients with PE were observed lower rates of vital lung capacity (VLC) (42,4 ±3%),
while the FEV1 authentically did not differ.
Thrombosis of deep veins of the legs (DVT)(fig.1,...
Conclusion
Pulmonary embolism is one of the causes of an exacerbation of COPD and its frequency have we examined patients was 17.8%.
MSCT is highly effective method of early diagnostics of pulmonary embolism in patients with COPD.
The peculiarity of PE in this category of patients is predominantly combined bilateral defeat of various segments of the pulmonary artery and the highest percentage of lung infarctions.
CT-venography of the low extremity is effective method of identifying the causes of venous thrombosis.
This method may by used as...
References
Sharma GVRK,
Sasahara AA.
Diagnosis of pulmonary embolism in patients with chronic obstructive pulmonary disease.
J Chronic Dis.
1975; 28:253-7.
Winter J H,
Buckler P W,
Bautista A P.et alFrequency of venous thrombosis in patients with an exacerbation of chronic obstructive lung disease.
Thorax 1983.
38605–608.
Tillie‐Leblond I,
Marquette C H,
Perez T.et alPulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors.
Ann Intern Med 2006.
144390–396.
Erelel M,
Cuhadaroglu C,
Ece T.et alThe frequency of deep venous...
Personal Information
Section: Personal Information
I.M.
Koroleva,
MD,
I.A.
Sokolina
ADRESS CORRESPONDENCE TO:
Department of Radiology,
First Moscow State Medical University I.M.
Sechenov
119991 Moscow,
Russia,
Trubetskaya street,
8-2
tel.
(499) 248-73-07; tel./fax (499) 248-75-07; e-mail:
[email protected].