双源双能量CT肺栓塞指数和肺灌注缺损指数评价肺栓塞的相关研究

Correlation Research on Pulmonary Embolism Assessment with Dual-Source and Dual-Energy CT Pulmonary Embolism Index and Pulmonary Per Fusion Defect Index

目的评价双源CT双能量肺动脉血管成像(CTPA)肺栓塞指数和肺灌注成像(DEPI)肺灌注缺损指数的相关性及一致性。方法经CTPA确诊肺栓塞60例,数据经工作站处理得到CTPA图像和DEPI,由2名高年资诊断医师分别独立评价CTPA图像和DEPI图像并进行指数计算,分别对2名医师测量数据、肺栓塞指数与肺灌注缺损指数之间进行Person相关性分析和Bland-Altman一致性分析。然后取2名医师测量指数的平均数对中央型肺栓塞、周围型肺栓塞的肺栓塞指数及肺灌注缺损指数分别进行Person相关性分析和Bland-Altman一致性分析。结果医师1测量肺栓塞指数和肺灌注缺损指数相关系数为0.831,一致性mean(差值的均数)为3.2;医师2测量肺栓塞指数和肺灌注缺损指数相关系数为0.843,一致性mean为3.2;医师1与医师2测量肺栓塞指数相关系数为0.997,一致性mean为0.3;医师1与医师2测量肺灌注缺损指数相关系数为0.993,一致性mean为0.4。中央型肺栓塞指数与肺灌注缺损指数相关系数为0.86,一致性mean为6.9;周围型肺栓塞指数与肺灌注缺损指数相关系数为0.863,一致性mean为0.2。结论肺栓塞指数与肺灌注缺损指数具有高度相关性,两者都能量化肺栓塞程度,但中央型肺栓塞栓塞指数和肺灌注缺损指数一致性有差异,临床应当联合应用,综合评估肺栓塞病情程度。

Objective To access the correlation and consistency of pulmonary embolism index derived from dual-source and dual-energy CT pulmonary angiography(CTPA) and pulmonary perfusion defect index derived from lung perfusion blood volume(PBV) in patients with pulmonary embolism. Methods Patients who were confirmed with pulmonary embolism accepted dual-source and dual-energy CT pulmonary angiography;the work station processed the data and obtained pulmonary artery vessel image and dual energy perfusion image(DEPI);two older doctors separately and independently accessed the CTPA image and DEPI image and conducted index calculation;person correlation analysis and Bland-Altman consistency analysis were separately conducted toward the doctors’ measured data,pulmonary embolism indexes and pulmonary perfusion defect indexes. Then,the average number of the doctors’ measure indexes was selected to conduct person correlation analysis and Bland-Altman consistency analysis toward pulmonary embolism index and pulmonary perfusion defect index of central type pulmonary embolism and peripheral pulmonary embolism. Results The correlation coefficient of Doctor 1’s measured pulmonary embolism index and pulmonary perfusion defect index was 0.831 and the consistency mean(average number of the deviation) was 3.2;the correlation coefficient of Doctor 2’s measured pulmonary embolism index and pulmonary perfusion defect index was 0.843 and the consistency mean was 3.2;the correlation coefficient of Doctor 1’s and Doctor 2’s pulmonary embolism index was 0.997 and the consistency mean was 0.3;the correlation coefficient of Doctor 1’s and Doctor 2’s pulmonary perfusion defect index was 0.993 and the consistency mean was 0.4;the correlation coefficient of pulmonary embolism index and pulmonary perfusion defect index for central type pulmonary embolism was 0.86 and the consistency mean was 6.9;the correlation coefficient of pulmonary embolism index and pulmonary perfusion defect index for peripheral pulmonary embolism was 0.863 and the consistency mean was 0.2. Conclusion Pulmonary embolism index possesses high correlation with pulmonary perfusion defect index;both of them are able to quantify the degree of pulmonary embolism. However,the difference exists in the consistency of the pulmonary embolism index and the pulmonary perfusion defect index for the central type pulmonary embolism. Thus,both of them shall be combined to comprehensively access pulmonary embolism illness degree clinically.