急性肺栓塞双能量能谱CT碘基物质图联合肺灌注缺损指数的运用价值

Analysis of the application value of dual energy spectrum CT iodine based substance map combined with pulmonary perfusion defect index in acute pulmonary embolism

目的 探讨急性肺栓塞(APE)双能量能谱CT碘基物质图联合肺灌注缺损指数(PPDI)的运用价值。方法 选取我院APE患者64例作为APE组;另选同期慢性肺栓塞(CPE)患者60例作为CPE组,均行双能量能谱CT肺血管成像技术检查,对0.625 mm层厚的原始数据运用ISP工作站(与1.2.2图像处理相对应)软件后处理,获得碘密度图及PPDI。测量碘含量取平均值;PPDI=∑(n1×d1/40)×100%。比较APE组与CPE组碘基物质图定量特征和PPDI变化;比较APE不同危险分层碘基物质图定量特征和PPDI变化;采用ROC曲线分析PPDI联合碘基物质图定量对APE预测价值。结果 APE组肺异常灌注区碘含量和肺动脉栓塞区碘含量低于CPE组,差异有统计学意义(P<0.05)。APE组PPDI高于CPE组,差异有统计学意义(P<0.05)。中高危患者肺异常灌注区碘含量和肺动脉栓塞区碘含量低于低危患者,差异有统计学意义(P<0.05)。中高危患者PPDI高于低危患者,差异有统计学意义(P<0.05)。经ROC曲线分析,PPDI联合碘基物质图定量对APE预测灵敏度和特异度高于PPDI与碘基物质图定量,差异有统计学意义(P<0.05)。结论 双能量能谱CT碘基物质图联合PPDI预测急性肺栓塞灵敏度和特异度良好,具有很好的诊断价值。

Objective To explore the application value of dual energy spectrum CT iodine based substance map combined with pulmonary perfusion defect index in acute pulmonary embolism.Methods 64 APE patients were selected from our hospital from March 2021 to March 2023.In addition,60 patients with chronic Pulmonary embolism(CPE)in our hospital from March 2021 to March 2023 were selected as control study,all of whom underwent dual energy spectrum CT pulmonary vascular imaging technology examination.The raw data with a thickness of 0.625 mm were post-processed using AW 4.7 workstation GSI software to obtain iodine based substance maps and PPDI.Then,we measured the iodine content and the average value(PPDI=∑(n1×d1/40)×100%),compared the quantitative characteristics and PPDI changes of iodine based substance maps between the APE group and the CPE group,and compared the quantitative characteristics and PPDI changes of iodine based substance maps in different risk stratification of APE.The quantitative prediction value of PPDI combined with iodine based substance map for APE was conducted using ROC curve analysis.Results The iodine content in the anomalous pulmonary perfusion area and pulmonary artery embolism area in APE group were lower than those in CPE group(P<0.05).The PPDI in APE group was higher than CPE group(P<0.05).The iodine content in the lung perfusion area and pulmonary artery embolism area in medium to high-risk group were lower than those in low risk group(P<0.05).The PPDI in medium to high-risk group was higher than that in low-risk group(P<0.05).Through ROC curve analysis,the sensitivity and specificity of PPDI combined with iodine based substance map quantification in predicting APE were higher than those of PPDI combined with iodine based substance map quantification(P<0.05).Conclusion The dual energy spectrum CT iodine based substance map combined with PPDI has good sensitivity and specificity in predicting acute pulmonary embolism,which has good diagnostic value.