CTPA与DEPI在高龄肺栓塞患者疗效评估中的价值

Value of CTPA and DEPI in the Efficacy of Elderly Patients with Pulmonary Embolism

目的探讨CT肺血管造影(CT pulmonary angiography,CTPA)与双能量肺灌注成像(dual-energy pulmonary perfusion imaging,DEPI)在高龄肺栓塞患者疗效评估中的临床价值。方法回顾性分析68例高龄肺栓塞患者临床资料,患者肺栓塞治疗前后均行CTPA、DEPI,分析所有患者治疗前后CTPA显示肺栓塞位置、数目和类型,DEPI检查中肺动脉血容量(pulmonary blood volume,PBV)显示图像灌注情况,利用勾画法计算栓塞区与对照区肺组织灌注ΔCT值。结果治疗前后患者肺栓塞位置分布(治疗前:中央70.69%,外周29.31%;治疗后:中央51.16%,外周48.84%)、肺灌注情况(治疗前:灌注正常:0.00%,灌注轻度减低63.79%,灌注减低27.01%;治疗后:灌注正常:75.29%,灌注轻度减低18.39%,灌注减低6.32%),差异均有统计学意义(P<0.05);治疗前后患者肺栓塞类型差异无统计学意义(P>0.05);治疗后肺灌注ΔCT值(24.41±4.52)mm,低于治疗前(56.68±9.56)mm,差异有统计学意义(P<0.05)。治疗后,CTPA显示无肺栓塞,而DEPI显示灌注轻度降低的部位3个,CTPA显示非闭塞型肺栓塞而DEPI显示灌注正常的部位3个。结论CTPA能体现治疗前后肺栓塞个数变化,DEPI可对CTPA结果进行补充,CTPA与DEPI用于高龄肺栓塞患者疗效评估中的临床价值较高。

Objective To explore the clinical value of CT pulmonary angiography(CTPA)and dual-energy pulmonary perfusion imaging(DEPI)in the efficacy evaluation of elderly patients with pulmonary embolism.Methods The clinical data of 68 elderly patients with pulmonary embolism were retrospectively analyzed.CTPA and DEPI were performed before and after pulmonary embolism treatment.The location,quantity and type of pulmonary embolism by CTPA and the image perfusion displayed by pulmonary blood volume(PBV)in DEPI examination were analyzed among all patients before and after treatment.The delineation method was used to calculate theΔCT value of pulmonaryissue perfusion in the embolized area and the control area.Results Location distribution of pulmonary embolism in patients before and after treatment(before treatment:central:70.69%,peripheral:29.31%;after treatment:central:51.16%,peripheral:48.84%)and pulmonary perfusion(before treatment:normal perfusion:0.00%,mildly reduced perfusion:63.79%,reduced perfusion:27.01%;after treatment:normal perfusion:75.29%,mildly reduced perfusion:18.39%,reduced perfusion:6.32%).The difference was statistically significant(P<0.05),and there was no significant difference in the type of pulmonary embolism before and after treatment(P>0.05).TheΔCT value of pulmonary perfusion after treatment(24.41±4.52)mm was lower than that before treatment(56.68±9.56)mm,the difference was statistically significant(P<0.05).After treatment,CTPA showed no pulmonary embolism while DEPI showed 3 sites with mildly reduced perfusion,and CTPA showed non-occlusive pulmonary embolism and DEPI showed 3 sites with normal perfusion.Conclusion CTPA can reflect the changes in the number of pulmonary embolism before and after treatment,and DEPI can supplement the results of CTPA.CTPA and DEPI have higher clinical value in the efficacy evaluation of elderly patients with pulmonary embolism.