双源CT胸部平扫对肺动脉栓塞的诊断价值

Diagnostic value of dual-source CT chest scan for pulmonary embolism

目的利用双源CT高、低管电压优势行胸部平扫研究肺动脉栓塞(PE),观察分析肺动脉腔内密度异常区的平均CT值的差异性,分析研究临床肺动脉栓塞的诊断意义。方法收集2018年12月至2020年12月汉中市中心医院经双源CT高、低管电压筛查的肺动脉CTA确诊的PE患者232例及肺动脉正常病例80例,对其平扫图像资料进行后处理,测量肺动脉腔内异常密度区域及正常病例的平均CT值,并进行统计学分析。结果232例确诊PE患者中,肺动脉腔内图像局限性密度减低者156例,局限性密度升高者76例;低管电压低密度区域平均CT值为(25.362±0.164)Hu,高密度区域平均CT值为(35.651±0.252)Hu;高管电压高密度区域平均CT值为(64.027±0.516)Hu,低密度区域平均CT值为(60.054±0.684)Hu。低管电压高、低密度病灶CT值与高管电压高、低密度病灶CT值及正常区域高、低管电压图像平均CT值比较,差异有统计学意义(P<0.05);高、低管电压高、低密度病灶CT值与正常区域高、低管电压图像CT值比较,差异无统计学意义(P>0.05)。结论双源CT低管电压平扫能更清晰地显示出肺动脉密度差异,能够诊断肺动脉栓塞,可为临床提示PE存在,进行及早治疗,并可以择期进行增强CT检查。

Objective To observe and analyze the variability of mean CT values of abnormal density areas in the pulmonary artery cavity by using dual-source CT chest scan with high/low tube voltage,and to analyze and study the diagnostic significance of clinical pulmonary embolism(PE).Methods The data of 232 patients with PE screened by dual-source CT with high/low tube voltage and diagnosed by pulmonary computed tomography angiography(CTA)in Hanzhong Central Hospital from December 2018 to December 2020,and of 80 cases with normal pulmonary arteries were collected for this study.These subjects’plain scan image data were post-processed for the measurement of the mean CT values(including the mean CT value of abnormal density areas in the pulmonary artery cavity of PE patients,and of cases with normal pulmonary arteries)and statistical analysis.Results 156 of 232 PE patients had decreased limited density in pulmonary artery cavity,with the rest 76 patients had increased limited density.The mean CT value was(25.362±0.164)Hu for the low-tube voltage and low-density areas,and was(35.651±0.252)Hu for the low-tube voltage and high-density areas.Meanwhile,the mean CT value was(64.027±0.516)Hu for the high-tube voltage and high-density areas,and was(60.054±0.684)Hu for the high-tube voltage and low-density areas.There were statistically significant differences in the CT values among low-tube voltage and high/low-density lesions,high-tube voltage and high/low-density lesions,and high/low-tube voltage images in normal areas(P<0.05).However,there were no statistically significant differences in the CT values between high/low-tube voltage and high/low-density lesions and high/low-tube voltage images in normal areas(P>0.05).Conclusion Dual-source CT plain scan with low-tube voltage can show the differences in pulmonary artery density more clearly and can indicate the presence of PE for clinical purposes and early treatment or pro mote elective enhanced CT examination for PE.