DELPI联合CTPA诊断肺栓塞的价值

Diagnostic value of DELPI associated with CTPA in pulmonary artery embolism

目的探讨双源CT双能量肺灌注成像(DELPI)联合肺动脉CT造影(CTPA)在诊断肺栓塞(PE)中的价值。方法选取2017年2月-2018年2月天津市武清区人民医院经CTPA扫描确诊为PE的患者60例作为观察组,另外选取同一时期行CTPA检查未见PE的患者60例为对照组。将这两组患者的CTPA图像分别在工作站生成的DELPI图像进行比较。总结出PE患者的DELPI特征性表象及常见假阳性征象。结果典型的PE DELPI图上显示表现为不规则灌注异常区。而在所有患者的非PE的部分区域也可以见到这样的灌注异常区,表现为灌注减低和灌注缺损。结论虽然DELPI在诊断PE上有其特征的表现,但是假阳性也比较多见,需要结合CTPA图像进行鉴别。

Objective To discuss the diagnostic value of dual-source CT dual-energy lung perfusion(DELPI)associated with multidetector CT pulmonary angiography(CTPA)in pulmonary embolism(PE).Methods 60 patients with PE diagnosed by CTPA in Tianjin Wuqing District People’s Hospital from February 2017 to February 2018 were selected as observation group,and another 60 patients without PE detected by CTPA in the same period were selected as control group.The CTPA images of the two groups were compared by the DELPI images generated at the workstation.The characteristic and common false positive signs of DELPI in PE patients were summarized.Results Typical PE DELPI images showed irregular perfusion anomalies.Such perfusion abnormalities can also be seen in some non-PE areas of all patients,manifesting as hypoperfusion and perfusion defect.Conclusion Although DELPI has its own characteristics in the diagnosis of PE,false positives are more common and need to be identified with CTPA images.