双源双能量CT诊断周围型肺动脉栓塞的价值

焦志云; 李郑; 徐文娟; 管懋彬; 翟润亚; 张美玲

doi:10.7619/jcmp.20201690

双源双能量CT诊断周围型肺动脉栓塞的价值

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

摘要

摘要:
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。

Abstract:
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.

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