IQon能谱CT碘图与单能量图对肺栓塞诊断的准确率对比

Comparative Study on the Accuracy of IQon Spectral CT Iodine Map and Single Energy Map in the Diagnosis of Pulmonary Embolism

目的:对比IQon能谱CT碘图与单能量图对肺栓塞诊断的准确率。方法:选择2020年6月-2022年6月在苏州科技城医院进行CT检查的100疑似肺栓塞患者,所有患者均使用能谱模式进行扫描,通过系统软件对患者的CT碘图与单能量图进行分析,以肺动脉CT血管造影(CT angiography,CTA)为金标准,对比两种图像对肺栓塞检查的准确率、特异度、敏感度及肺动脉栓子诊断符合率。结果:100例疑似肺栓塞患者经肺动脉CTA检查确诊的患者88例,12例为非肺栓塞,碘图对肺栓塞诊断的准确率为97.00%,单能量图诊断的准确率为85.00%,碘图高于单能量图(P<0.05);碘图敏感度、特异度、阳性预测值、阴性预测值分别为97.73%、91.67%、98.90%、91.70%,单能量图诊断的敏感度、特异度、阳性预测值、阴性预测值分别为87.50%、66.67%、95.10%、42.11%,碘图与单能量图敏感度和阴性预测值差异均有统计学意义(P<0.05),特异度、阳性预测值差异均无统计学意义(P>0.05);在88例确诊患者中,肺动脉CTA检测出栓子共计106个,其中1级栓子数量为21个,2级37个,3级25个,4级23个;碘图检出1级栓子数量符合21个,2级36个,3级25个,4级22个;单能量图检出1级栓子数量符合15个,2级30个,3级18个,4级17个;碘图检查的符合率高于单能量图检查(P<0.05)。结论:碘图检查的准确率、敏感度、阴性预测值均高于单能量图,对于微小肺动脉栓子检查的符合率高于单能量图,为临床治疗提供依据。

Objective:To compare the accuracy of IQon spectral CT iodine map and single energy map in the diagnosis of pulmonary embolism.Method:A total of 100 patients with suspected pulmonary embolism who underwent CT examination in Suzhou Science and Technology City Hospital from June 2020 to June 2022 were selected.All patients were scanned with energy spectrum mode,and the CT iodine map and single energy map of patients were analyzed by system software.Using CT angiography of pulmonary artery(CTA)as the gold standard,the accuracy,specificity,sensitivity of the two images for pulmonary embolism and the coincidence rate of emboli in the pulmonary artery were compared.Result:Among the 100 patients with suspected pulmonary embolism,88 patients were diagnosed by pulmonary CTA,and 12 patients were diagnosed as non-pulmonary embolism.The diagnostic accuracy of iodine map for pulmonary embolism was 97.00%,and the diagnostic accuracy of single energy map was 85.00%,diagnostic accuracy of iodine map was higher than that of single energy map(P<0.05).The sensitivity,specificity,positive and negative predictive values of iodine map were 97.73%,91.67%,98.90%,91.70%,respectively.The specificity,sensitivity,positive and negative predictive values of single energy map were 87.50%,66.67%,95.10%,42.11%,respectively.The sensitivity and negative predictive value of iodine map and single energy map were statistical different(P<0.05),and the specificity,positive predictive value were not statistical different(P>0.05).A total of 106 emboli were detected in the 88 patients with pulmonary artery CTA,including 21 emboli in grade 1,37 in grade 2,25 in grade 3 and 23 in grade 4.Iodine map detected for conformity 21 emboli of grade 1,36 of grade 2,25 of grade 3,and 22 of grade 4.Single energy map detected for conformity 15 emboli in grade 1,30 in grade 2,18 in grade 3,and 17 in grade 4.The coincidence rate of iodine map was higher than that of single energy map(P<0.05).Conclusion:The accuracy,sensitivity and negative predictive value of iodine map are higher than those of single energy map,and the coincidence rate of iodine map for small pulmonary emboli is higher than that of single energy map,which provides a basis for clinical treatment.