双源CT双能量成像对周围型肺动脉栓塞的诊断价值  

The Diagnostic Value of Dual-Source Dual-Energy CT Pulmonary Angiography for Peripheral Pulmonary Embolism

作　　者：罗显丽 李邦国[1] 刘盼[1] 黄婷婷[1] 孙辉[1] 王梦[1] 张雪梅[1] 

机构地区：[1]遵义医学院附属医院放射科,563003

出　　处：《临床放射学杂志》2017年第5期668-672,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81460265)

摘　　要：目的探讨双源CT双能量肺动脉成像Lung PBV、Lung Vessels软件对周围型肺动脉栓塞(PE)的诊断价值。方法对临床怀疑PE的143例患者行Flash双源CT双能量肺动脉成像,在后处理工作站利用双能量软件Lung PBV和Lung Vessels对其中的111例患者进行彩色编码成像,得到Lung PBV图及Lung Vessels图。单独应用CTPA及CTPA分别结合Lung PBV、Lung Vessels软件对肺动脉有无栓塞以及栓塞的部位、数目进行诊断并记录,比较单独应用CTPA及CTPA分别结合Lung PBV、Lung Vessels软件对全部栓子及不同部位栓子的检出率。以P<0.05为差异有统计学意义。结果综合临床资料及CT检查,最后确诊PE 41例。单独应用CTPA发现38例(34.2%),CTPA联合双能量软件后发现41例(36.9%);共检出栓子150个,包括段动脉58个,亚段动脉64个,亚段以下动脉28个,其中2个亚段以下栓塞Lung PBV、Lung Vessels图清晰显示楔形低灌注及红色伪彩色标记的栓子而CTPA未见异常。单独应用CTPA对全部栓子、段动脉栓子、亚段动脉栓子及亚段以下动脉栓子的检出率分别为82%、98.3%、84.4%、42.9%,CTPA联合Lung PBV软件分别为96.7%、100%、96.9%、89.3%,CTPA联合Lung Vessels软件分别为98%、100%、98.4%、92.9%,CTPA联合应用Lung PBV、Lung Vessels软件对所有栓子、亚段动脉栓子及亚段以下动脉栓子的检出率明显高于单独应用CTPA(P<0.05),对肺段动脉栓子的检出CTPA单独应用与联合应用Lung PBV、Lung Vessels软件差异无统计学意义(P>0.05)。结论双源CT双能量肺动脉成像中采用CTPA联合Lung PBV、Lung Vessels软件可以提高周围型PE检出率,特别是亚段及亚段以下PE。Objective To investigate the value of Lung PBV and Lung Vessels software in dual-source CT dual-energy pulmonary angiography for diagnosing peripheral pulmonary embolism（PE）. Methods 143 patients with clinical suspicion of PE underwent CT pulmonary angiography with dual-energy technique on a flash dual-source CT scanner. All raw data of 111 patients with suspected PE was transported to a dedicated workstation and Lung perfusion blood volume images and Lung Vessels images were obtained by Lung PBV and Lung Vessels software with color-coded imaging. Two experienced ra- diologists read CTPA alone and combined CTPA with Lung PBV and Lung Vessels software respectively, and evaluated the presence or absence of emboli, counted the number and location of PE. The difference of CTPA alone and CTPA with Lung PBV and Lung Vessels software respectively in detection the total and different anatomical locations of emboli were compared. P 〈 0. 05 was considered statistically significant. Results According to clinical data and CT findings, the final diagnosis of PE was 41 cases. Of these, 38 cases （34.2%） and 41 cases （36.9%） were detected with analyzing CTPA alone and CTPA combined with Lung PBV or Lung Vessels software respectively. A total of 150 emboli were detected in 111 patients, of these, 58 emboli were located in segmental pulmonary arteries, with 64 in the subsegmental pulmonary arteries, 28 in secondary subsegmental or more distal pulmonary arteries, in which 2 secondary subsegmental pulmonary arteries color coded red on Lung Vessels and displayed wedge-shaped perfusion defects on Lung PBV without the visualization of endoluminal thrombi within the corresponding arteries on CTPA images. With CTPA alone, the detection rate for embolisms in all, segmental, subsegmental, and secondary subsegmental pulmonary arteries were 82%/98.3 %/83.4%/42.9% respectively; CTPA with Lung PBV software was 96.7%/100%/96.9%/89.3% , and CTPA with Lung Vessels software was 98%/100%/98.4%/92.9%. CTPA combined with Lung PBV and Lu

关 键 词：双源CT 双能量 血管造影术 肺动脉栓塞 

分 类 号：R563.5[医药卫生—呼吸系统]