双源CT双能量肺灌注成像在可疑肺栓塞患者的初步应用

The Preliminary Study of Dual Source CT Dual Energy Lung Perfusion Imaging in the Patients with Suspected Pulmonary Embolism

目的评价双源CT双能量肺灌注成像(DEPI)在可疑肺栓塞(PE)患者的临床诊断价值。资料与方法19例临床拟诊PE的患者在双源CT上行对比增强双能量模式扫描。利用双能量分析软件(LungPBV)分析。以肺叶为单位,记录DEPI和CT肺动脉成像(CTPA)上PE的数目和位置。以CTPA为参照标准,评价DEPI诊断PE的敏感性和特异性。分析DEPI上肺灌注异常的范围与心血管测量参数的关系。结果19例共行20次DECT扫描,共有98个肺叶纳入分析。10例未检出PE,9例确诊为PE,23个肺叶的肺动脉内可见充盈缺损。以CTPA为参照标准,两位医师利用DEPI诊断PE的敏感性、特异性分别为96%、96%和82%、95%。PE患者肺灌注异常的范围似与右室功能障碍有关。结论利用双源CT双能量模式扫描可同时获得全肺的解剖和功能信息,在PE的诊断和随访中有较高的临床价值。

Objective To assess the clinical value of dual source CT dual energy lung perfusion imaging in the diagnosis of suspected pulmonary embolism （PE）. Materials and Methods 19 patients with suspected PE received contrast enhanced dual source CT scanning with dual energy mode. The dedicated software of Lung PBV was used for image postprocessing. The number and location of PE indual energy perfusion imaging （DEPI）and CT pulmonary angiography （CT- PA） were recorded respectively. Sensitivity and specificity were measured comparing to CTPA as a standard of reference. The relationship between range of lung perfusion abnormality in DEPI and cardiovascular measurements was analyzed. Results 20 DEPI scans were performed in 19 patients. 9 patients had PE, while 10 patients had negative results. Filling defect was detected in pulmonary arteries in 23 pulmonary lobes. Comparing to CTPA as a standard of reference, sensitivity and specificity were 96%, 96% for reader 1 ;82%, 95% for reader 2 ,respectively. Range of lung perfusion may be related with fight ventricular failure. Conclusion DEPI can provide morphological and functional information of whole lungs, which has an important role in the diagnosis and follow-up of PE.