双源CT双能量肺灌注成像评价急性肺栓塞严重程度及右心功能的临床价值  

The clinical value of dual-energy CT lung perfusion imaging in the assessment of the severity of acute pulmonary embolism and the right ventricular function

作　　者：孔维芳[1] 蒲红[1] 王娜[1] 陈光文[1] 李迎春[1] 陶客言[1] 

机构地区：[1]四川省医学科学院.四川省人民医院放射科,四川成都610072

出　　处：《实用医院临床杂志》2016年第2期110-113,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨双源CT双能量肺灌注成像(dual energy perfusion imaging,DEPI)评价急性肺动脉栓塞(acute pulmonary embolism,APE)严重程度的可行性及临床价值。方法经双源多层螺旋CT肺动脉成像(computered tomography pulmonary angiography,CTPA)确诊的24例APE患者,观察DEPI图像肺灌注缺损的位置及形态,CTPA图像上肺动脉栓塞(PE)的位置、类型,测量双室短轴最大径,分别计算灌注缺损分数、栓塞分数及双室短轴最大径比(RV/LV)。根据临床指标分为严重组和非严重组,比较两组各指标的差异并进行相关性分析。结果以肺段为单位DEPI及CTPA诊断PE的符合率为83.958%,KAPPA系数值为0.658。严重组中灌注缺损分数、栓塞分数及RV/LV均显著高于非严重组(P<0.05)。灌注缺损分数与栓塞分数及RV/LV均有显著相关性(P<0.05)。结论肺灌注缺损分数评价APE的严重程度及右心功能有可行性及一定价值。Objective To investigate the feasibility and clinical value of dual-energy CT perfusion image（ DEPI） in the assessment of the severity of acute pulmonary embolism（ APE）.Methods The pulmonary perfusion defect position and shape on DEPI and the location and types of pulmonary embolism（ PE） on computered tomography pulmonary angiography（ CTPA） were observed in24 patients with APE that was confirmed by using CTPA. The ventricular short axis diameter was measure. The scores of perfusion defect,PE scores and maximum diameter ratio of right ventricle to left ventricle（ RV / LV） were calculated.The patients were divided into severe group and non-severe group according to clinical symptoms.The differences in the various indexes were compared between the two groups and the correlation analysis was also performed. Results The agreement rate of PE diagnosis between DEPI and CTPA was83. 958% per pulmonary segment and KAPPA coefficient was 0. 658.The scores of perfusion defect,PE scores and RV / LV ratio in the severe group were significantly higher than that in the non-severe group（ P 〈0. 05）.The scores of perfusion defect,PE scores and RV /LV ratio were significantly correlated（ P 〈0. 05）.Conclusion DEPI is feasible and helpful for assessing the severity and right ventricular function of APE.

关 键 词：双能量计算机断层成像 肺灌注 肺动脉栓塞 

分 类 号：R814.42[医药卫生—影像医学与核医学]