双源CT双能量肺灌注成像诊断肺栓塞

目的探讨双源CT双能量肺灌注成像在肺栓塞诊断中的临床应用价值。方法对12例临床怀疑肺栓塞的患者行双源CT双能量肺灌注成像。采用LungPBV软件进行数据后处理，得到CT肺血管图像（CTPA）、双能量肺灌注图像（DEPI）及两者融合图像，以叶为单位，观察肺动脉内有无栓子，记录栓子的位置及数目；分析DEPI影像学表现，记录肺内灌注异常的位置及数目。结果经Kappa分析，同一个观察者CTPA与DEPI分析结果均有较好的一致性（Kappa值分别为0．79、0．69，P-0．01），不同观察者之间DEPI分析结果有很好的一致性（Kappa-0．79，P-0．01）。结论双源CT双能量肺灌注成像能够显示由栓塞造成的肺灌注稀疏或者缺损区且有一定性的重复性；还可能用于肺栓塞治疗疗效的评估。

Dual-source CT dual-energy perfusion imaging for the diagnosis of pulmonary embolism

Objective To assess the diagnostic value of dual-source CT dual-energy perfusion imaging(DEPI) for pulmonary embolism. Methods Twelve consecutive patients with suspected pulmonary embolism underwent dual-energy imaging. The images were evaluated with lung PBV software on the workstation, then CTPA, DEPI and fusion image were obtained and reviewed by 2 board-certified radiologists independently. The presence or absence of the embolism was scored using a 5-point scale. The scores for pulmonary embolism on CTPA and DEPI were compared using a weighted Kappa analysis. Results There was moderate agreement between the judgement of the scores of CTPA and DEPI (Kappa value was 0.79 and 0.69, respectively, P=0.01), and perfect agreement between scores judged by different reviewers on DEPI(Kappa value was 0.79, P=0.01). Conclusion DEPI is of moderate agreement and good reproducibility in the diagnosis of pulmonary embolism.