双能量CT鉴别急慢性肺血栓栓塞的初步研究  

A preliminary study on the differential diagnosis of acute and chronic pulmonary thromboembolism using dual-energy CT

作　　者：杨熙斌 郭君武[1] 但锟 赵文敬 丁楠 YANG Xi-bi;LI Wei-wei;DAN Kun(Department of Radiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院放射科,郑州450000

出　　处：《放射学实践》2018年第12期1251-1255,共5页Radiologic Practice

摘　　要：目的:探讨DECT肺血管成像技术对急、慢性肺栓塞(APTE、CPTE)的诊断价值。方法:选取经临床确诊的肺栓塞患者36例,其中急性组(APTE)21例,慢性组(CPTE)15例,所有患者行DECT肺血管成像扫描,记录患者的基本临床资料,定量分析APTE和CPTE组中主肺动脉干(MPA)和栓子的增强CT值、强化值(△CT)和碘浓度(IC),计算两个部位各参数的比值(RCT、R△CT和RIC),并对两组中各参数的差异进行统计学分析。结果:APTE和CPTE组中栓子的增强CT值分别为(33.98±10.31)和(53.90±7.64)HU,△CT值分别为(21.00±9.10)和(33.63±7.34)HU,IC值分别为(1.14±0.48)和(1.84±0.49)mg/mL;3个参数值的组间差异均有统计学意义(P<0.05)。两组中RCT值分别为0.135±0.067和0.190±0.034,R△CT值分别为0.029±0.007和0.096±0.032,RIC值分别为0.106±0.038和0.157±0.047;各项比值的组间差异均有统计学意义(P<0.05)。两组中患者的D-2聚体浓度分别为(12.07±11.74)和(1.64±1.20)mg/L,右心室与左心室短径比值(RVd/LVd)分别为0.99±0.14和0.90±0.09,组间差异均有统计学意义(P<0.05)。结论:DECT肺血管成像定量分析技术可鉴别急性和慢性肺栓塞。Objective:To explore the value of dual-energy CT(DECT)pulmonary angiography in diagnosis of acute and chronic pulmonary thromboembolism(APTE,CPTE).Methods:36 patients with clinically diagnosed APTE(n=21)or CPTE(n=15)were included in this study,and their main clinical data were recored.All patients underwent DECT pulmonary angiography.Enhanced CT value,iodine-related CT value(△CT)and iodine concentration value(IC)of emboli and main pulmonary artery(MPA)were quantitatively analyzed,and the ratio of these parameters(R CT,R△CT,and R IC)were calculated.The differences of parameters mentioned above between APTE and CPTE groups were statistically analyzed.Results:There were significant differences in the enhanced CT,△CT and IC values of emboli in pulmonary artery between APTE and CPTE groups[(33.98±10.31)vs(53.90±7.64)HU;(21.00±9.10)vs(33.63±7.34)HU and(1.14±0.48)vs(1.84±0.49)mg/mL;all P<0.05].Significant differences were observed also in the R CT,R△CT and R IC between the two groups(all P<0.05);The R CT,R△CT,and R IC values in APTE and CPTE groups were(0.135±0.067)vs(0.190±0.034),(0.029±0.007)vs(0.096±0.032)and(0.106±0.038)vs(0.157±0.047),respectively.There were also significant differences in the D-dimer and RVd/LVd values between the two groups(both P<0.05);D-dimer and ratio of right and left ventricular maximum diameter on short axis(RVd/LVd)were(12.07±11.74)vs(1.64±1.20)mg/L and(0.99±0.14)vs(0.90±0.09),respectively.Conclusion:Quantitative analysis of DECT pulmonary angiography can be used to differentiate APTE and CPTE.

关 键 词：急性肺栓塞 慢性肺栓塞 体层摄影术 X线计算机 双能量CT 

分 类 号：R543.2[医药卫生—心血管疾病] R814.42[医药卫生—内科学]