双源CT双能量肺灌注成像对急性肺动脉栓塞诊断价值  

Dual Energy Perfusion Imaging Using Dual Source CT in the Diagnosis of Pulmonary Embolism

作　　者：贾飞鸽[1] 彭珂文[1] 汪春荣[1] 高慧[1] 古治梅[1] 高德宏[1] 谭四平[1] 沈比先[1] 

机构地区：[1]广东医学院附属深圳南山医院影像科,广东深圳518052

出　　处：《中国CT和MRI杂志》2013年第6期40-43,共4页Chinese Journal of CT and MRI

基　　金：深圳市南山区科技研发资金资助项目(2010043)

摘　　要：目的探讨双源CT双能量肺灌注成像(DEPI)对急性肺动脉栓塞的诊断价值。方法 25例怀疑急性肺动脉栓塞患者行双源CT进行双能量扫描,所得数据采用Dual Energy软件处理得到肺灌注图像,同时得到肺动脉CTA图像,将肺组织灌注状态按肺叶、肺段、肺亚段与CTA上所示肺动脉栓塞进行记录,对比分析肺灌注与肺动脉栓塞之间的关系。结果 CTA共检出21个肺叶、47个肺段、37个亚段内有血栓存在。DEPI检出肺叶灌注稀疏或缺失20个,符合率为95.2%;肺段灌注稀疏或缺失42个,符合率为89.4%;亚段灌注稀疏或缺失33个,符合率89.2%。当肺段、亚段动脉栓塞完全栓塞时,相应DEPI的灌注缺失主要是以肺段或亚段分布;当肺动脉部分栓塞时,DEPI以灌注稀疏为主,少数表现为无灌注缺失;7个肺段区显示灌注缺失,而CTPA未见到血栓。结论 DEPI能够显示肺动脉栓塞导致肺血流改变的肺灌注异常,与CTPA联合起来有助于提高急性肺动脉栓塞诊断率。Objective To assess the clinical value of dual source CT dual energy lung perfusion imaging in the diagnosis of suspected pulmonary embolism （PE）. Methods 25 patients with suspected PE received contrast enhanced dual source CT scanning with dual energy mode. The dedicated sol.rare of Dual Energy was used for image post-processing. The number and location of PE in dual ener~ pergasion imaging （DEPI） and CT pulmonary angiography （CTPA） were recorded respectively. Sensitivity and specificity were measured comparing to CTPA as a standard of reference. The relationship between range of lung perfusion abnormality in DEPI and cardiovascular measurements was analyzed. Result21 lobes, 47 segnaental and 37 sub-segmental were involved with puhnonarv embolism. The 95.2%, 89.4% and 89.2% agreement between DEPI and CTPA were showed in the levels of lung and partial lung respectively. Complete filling defects of segmental and sub-segnlental pulmonary arteries mostly showed correspondence perfusion defects in the CT perfusion map. However, when there were partial filling defects, most of them were partial perfusion defects. A few of them were normal in the CT perflasion map. Otherwise, segn^ental peffusion defects were depicted without the visualization of endo-luminal thrombi in some patients. Conclusions DEPI may reveal abnormal per/usion resulted by PE. The combination of CTPA and DEPI will offer more infomation for diagnosis of the acute pulmonary embolism.

关 键 词：双源CT 双能量肺灌注成像 肺栓塞 

分 类 号：R543.2[医药卫生—心血管疾病]