宝石能谱CT成像碘基图在肺栓塞诊断中的应用价值  

The application value of gemstone spectral CT imaging iodine ghitu in diagnosis of pulmonary embolism

作　　者：宋红岩[1] 木合拜提.买合苏提 叶梅[1] 杨文[1] 肖虎[1] 王海涛[1] 孙亚菁[1] SONG Hongyan Muhebaiti Maihesuti YE Mei YANG Wen XIAO Hu WANG Haitao SUN Yajing(Department of Imaging Center, the First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, Chin)

机构地区：[1]新疆医科大学第一附属医院影像中心,乌鲁木齐830054

出　　处：《新疆医科大学学报》2017年第6期743-746,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2014211C057)

摘　　要：目的探讨宝石能谱CT成像碘基图在肺栓塞中的诊断价值。方法对新疆医科大学第一附属医院2015年1月-2016年5月临床高度怀疑肺栓塞的80例患者行宝石能谱增强扫描,在CT肺血管造影图像(CTPA)上确诊肺栓塞20例,通过数据后处理,获得常规CTPA图像及碘基物质图像。在CTPA图像上观察肺动脉内栓子的分布情况,记录栓子的数目及栓子类型;观察不同类型栓子引起供血区的碘含量变化。采用GSI Viewer软件包定量测定正常肺组织与栓塞区肺组织的碘含量值,并进行比较。结果经CTPA图像上确诊肺栓塞的20例患者,共发现101个栓子,其中肺叶栓子25个,肺段栓子59个,亚段栓子17个;61个栓子为完全型,均显示为远端灌注减低,41个栓子为不完全型,其中14个栓子显示为远端灌注减低,完全型栓塞出现灌注减低的比例高于不完全型栓塞出现灌注减低的比例,两者比较差异有统计学意义(χ~2=53.929,P=0.000)。不完全型栓塞中包括中心型栓子6个,偏心型栓子30个,附壁型栓子5个;栓塞区与对照区碘含量分别为(9.56±5.96)g/L和(15.58±6.68)g/L,两者比较差异有统计学意义(P<0.05);完全型栓塞中栓塞区与对照区碘含量分别为(6.22±3.60)g/L和(16.92±6.94)g/L,两者比较差异有统计学意义(P<0.05),中心型栓子栓塞区与对照区碘含量分别为(10.73±5.02)g/L和(12.54±5.72)g/L,两者比较差异无统计学意义(P>0.05);偏心型栓子栓塞区和对照区的碘含量分别为(11.18±5.82)g/L和(14.33±6.18)g/L,两者比较差异有统计学意义(P<0.05);附壁型栓子栓塞区和对照区的碘含量分别为(18.47±7.02)g/L和(18.62±7.90)g/L,两者比较差异无统计学意义(P>0.05)。结论宝石能谱CT可以观察肺内栓子的形态及分布情况,提供发生肺栓塞时不同类型栓子引起的肺灌注改变的信息,同时可以作为评估病情的重要方法。Objective To explore the diagnostic value of iodine diagram of gemstone energy spectrum CT imaging in the diagnosis of pulmonary embolism. Methods Eighty patients with suspected pulmonary em- bolism were enrolled in our hospital from Jan, 2015 to May, 2016. Twenty patients with pulmonary em- bolism were diagnosed by CT pulmonary angiography （CTPA）. a conventional CTPA image and an iodine- based substance image were obtained. The number ,location and type of perfusion defected were recorded. Observed were the changes of iodine content in the blood supply area caused by different types of emboli. The content of iodine in normal lung tissue and the content of iodine in lung tissue of embolized area were quantitatively measured by GSI Viewer software package. Results Twenty patients with suspected pulmo- nary embolism diagnosed by CTPA were found to have 101 clots, including lobar （n =25）, segmental （n=59）, sub-segmental （n =17）. 60 clots were occlusive based material decomposition images of all occlu- sive clots showed lobar, the iodine-and 41 clots were non-occlusive, whereas fourteen of 41 non-occlusive clots had evidence of iodine distribution defects. There was significant difference （）C2 = 53.929, P = 0.000） in the perfusion defects between occlusive and non-occlusive clots. Non-occlusive including central clots （n ~6）, eccentric clots （n =30）, mural thrombus （n =5） ; Embolism areas and contrasted iodine content re- spectively （9.56 ± 5.96） g/L and （15.58 ± 6.68） g/L, the difference was statistically significant （P 〈 0.05）; complete embolism area and the contrasted areas iodine content respectively （6.22±3.60） g/L and （16.92±6.94） g/L, the difference was statistically significant （P 〈0.05）, central embolic areas and con- trasted iodine content respectively （10.73±5.02） g/L and （12.54±5.72） g/L, the difference was not sta- tistically significant （P 〉0.05）; the iodine content of eccentric embolism areas and contrasted areas were （

关 键 词：肺栓塞 能谱CT 碘基图 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学]