双源双能量CT诊断周围型肺动脉栓塞的价值

目的探讨双源双能量CT对周围型肺动脉栓塞的诊断价值。方法从临床怀疑肺动脉栓塞(PE)并行双源双能量CT肺动脉成像的患者中选择周围型PE患者36例(98个栓子)纳入本研究。运用Syngo.via工作站对双源双能量CT扫描数据进行CT肺动脉血管成像(CTPA)和CT双能量Lung Analysis后处理。记录PE的栓塞部位及栓子数量,采用配对χ²检验比较2种后处理方法对周围型PE的诊断效能。结果CTPA共检出PE栓子85个,包括段动脉44个,亚段动脉及亚段以下动脉41个。CT双能量Lung Analysis软件结合Lung PBV和Lung Vessels共检出栓子94个,包括段动脉43个,亚段动脉42个,亚段以下动脉9个。CT双能量Lung Analysis对周围型PE栓子的检出率高于CTPA,差异有统计学意义(χ²=5.217,P=0.022),其中以亚段及亚段以下动脉差异更为显著(χ²=8.230,P=0.004)。结论CT双能量Lung Analysis结合Lung PBV和Lung Vessels能直接显示栓子位置及其所致的肺灌注异常情况,对周围型PE具有较高的诊断效能,特别是能提高亚段及亚段以下PE栓子的检出率。

Value of dual-source and dual-energy CT in diagnosis of peripheral pulmonary embolism

Objective To investigate the the diagnostic value of dual-source and dual-energy CT for peripheral pulmonary embolism.Methods Among the patients with clinical suspected pulmonary embolism(PE)and dual-source and dual-energy CT pulmonary angiography,36 cases(98 emboli)of peripheral PE were included in the study.Syngo.via workstation was used to perform post-processing of CT pulmonary angiography(CTPA)and CT dual-energy Lung Analysis on the dual-source dual-energy CT scan data,and the PE embolization sites and the number of emboli were recorded.Chi-square test was used to compare the diagnostic efficacy of the two post-processing methods for peripheral PE.Results CTPA detected a total of 85 PE emboli,including 44 in segmental arteries,41 in sub-segmental arteries and distal pulmorany arteries.CT dual-energy Lung Analysis software combined with lung perfusion defect of lung perfusion blood volume(Lung PBV)and Lung Vessels detected 94 emboli,including 43 in segmental arteries,42 in sub-segment arteries,and 9 in sub-segmental arteries or more distal pulmorany arteries.The detection rate of peripheral PE emboli by CT dual-energy Lung Analysis was significantly higher than that of CTPA(χ²=5.217,P=0.022),and more difference were found in subarterial and more distal pulmorany arteries(χ²=8.230,P=0.004).Conclusion CT dual-energy Lung Analysis combined with Lung PBV and Lung Vessels can directly show the embolism locations and the abnormal pulmonary perfusion,and has a higher diagnostic efficiency for peripheral PE,especially for sub-segment and sub-segment below PE.