双源CT双能量肺动脉成像结合灌注血池容积技术评价急性肺栓塞的初步研究  

Pulmonary Angiography with Perfusion Blood Volume by Dual-Energy CT in Diagnosis of Patients with Acute Pulmonary Embolism: Preliminary Results

作　　者：沈起钧[1,2] 彭志毅[1] 单嫣娜[1] 陈文辉[1] 周合山[1] 

机构地区：[1]浙江大学附属第一医院放射科,在职研究生310006 [2]杭州市第一人民医院

出　　处：《临床放射学杂志》2014年第1期34-38,共5页Journal of Clinical Radiology

基　　金：杭州市卫生局课题(编号:2013A13)

摘　　要：目的探讨双源CT双能量肺动脉成像结合灌注血池容积(PBV)技术评价急性肺栓塞的诊断价值。方法对48例临床诊断肺栓塞患者进行CT肺动脉造影(CTPA)及PBV成像,所得图像以肺叶及肺段为评价单位,分别对CTPA血管内栓子数量及栓塞程度,PBV灌注缺损区平均CT值及碘含量值进行统计,分析其相关性。结果48例患者除3例有不同程度支气管炎、肺气肿、肺间质纤维化或胸腔积液,双肺表现为弥漫灌注降低,未纳入统计;其余共有225个肺叶和肺叶动脉,720个肺段和肺段动脉纳入分析。其中78个肺叶、171个肺段内有栓子存在。以肺叶为评价单位,PBV共检出灌注缺损或降低75个,CTPA检出相应的血管栓塞78个,符合率为96.2%;以肺段为评价单位,PBV共检出156个肺段有灌注缺损或降低,与CTPA检出171个栓子的符合率为91.2%,病变区域的PBV图(包括CT值及碘含量)与肺栓塞的有无及栓塞的程度存在显著统计学差异。结论双源CT双能量肺动脉成像结合PBV技术有助于提高对急性肺栓塞的诊断正确率。Objective To assess the diagnostic value of Pulmonary angiography with perfusion blood volume by dual- energy CT in patients with acute pulmonary embolism. Methods 48 clinical patients with acute pulmonary embolism un- derwent dual-energy imaging, the images were evaluated with lung PBV software on the syngo via workstation, after CT pul- monary angiography（CTPA）. All images were based on branches and sub -branches, the number and location of PE in CTPA and PBV were recorded and analyzed. Results 225 branches and 720 sub - branches were recorded and analyzed except 3 patients with bronchitis, pulmonary emphysema, pulmonary fibrosis or pleural effusion. 78 branches and 171 sub - branches were involved with pulmonary embolism. Basing on branches, 96.2% agreement between CTPA （78） and PBV （75）. Basing on sub- branches, 91.2% agreement between CTPA（ 171 ） and PBV（156）. There was a significant differ- ence between the CT or Iodine value in PBV and severity of embolism. Conclusion Pulmonary angiography with perfusion blood volume by dual energy CT can offer more information for diagnosis of the acute pulmonary embolism.

关 键 词：肺栓塞 体层摄影术 X线计算机 肺灌注 肺动脉造影 

分 类 号：R563.5[医药卫生—呼吸系统]