Value of dual-source and dual-energy CT in diagnosisof 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.