能谱CT肺动脉造影碘基物质成像技术在段以下肺动脉栓塞中的应用  

Application of energy-spectral computed tomographic pulmonary angiography using iodine-based material imaging technology to pulmonary embolism below bronchopulmonary segments

作　　者：韦学[1] 丁可[1] 赵晓英[1] 毛艳[1] 陈炯[1] 黄瑞岁[1] WEI Xue;DING Ke;ZHAO Xiao-ying;MAO Yan;CHEN Jiong;HUANG Rui-sui(Department of Radiology,the Second Nanning People's Hospital,Nanning 530031,China)

机构地区：[1]广西南宁市第二人民医院放射科,南宁市530031

出　　处：《广西医学》2020年第11期1369-1372,共4页Guangxi Medical Journal

摘　　要：目的探讨能谱CT肺动脉造影(CTPA)碘基物质成像技术对段以下肺动脉栓塞的评估效果。方法对32例段以下肺动脉栓塞患者进行能谱CTPA,并在普通CTPA混合能量图上进行多平面重建显示栓子的数量,观察肺纹理改变及密度减低情况。利用碘水分离技术重建出能谱CTPA碘基物质图,通过多平面重建显示栓子的数量,同时肉眼观察碘灌注减低区,并测量其及对应正常肺组织的碘含量。结果在能谱CTPA碘基物质图像上直接发现的栓子65个,碘灌注减低区72个;在普通CTPA混合能量图上仅发现栓子42个,明确有肺纹理改变及密度减低区的栓子仅8个。72个碘灌注减低区碘含量低于正常对比区,各肺叶中碘灌注减低区的碘含量均低于正常对比区(均P<0.05)。结论与普通CTPA比较,能谱CTPA可更好地直接显示肺栓子,并能通过碘基物质测定为段以下肺动脉栓塞的诊断提供依据。Objective To investigate the efficacy of energy-spectral computed tomographic pulmonary angiography(CTPA)using iodine-based material imaging technology in evaluation of pulmonary embolism below bronchopulmonary segments.Methods Thirty-two patients with pulmonary embolism below bronchopulmonary segments underwent energy-spectral CTPA,moreover,in the mixed energy images on common CTPA multiplanar reconstruction was conducted for displaying the embolus count,and the changes in lung markings and phenomenon of decreased density were observed.Energy-spectral CTPA iodine-based material decomposition images were reconstructed by a method for separation of iodine species from water,and then the embolus count was displayed after multiplanar reconstruction;besides,the areas with decreased iodine perfusion was observed by unaided eyes,and the iodine contents of those areas and the corresponding normal lung tissues were measured.Results In the energy-spectral CTPA iodine-based material decomposition images,65 emboli were found by unaided eyes and 72 areas with decreased iodine perfusion were observed;in the mixed energy images on common CTPA,only 42 emboli were found,and only 8 emboli were found in the areas with definite lung markings change and decreased density.The iodine content was less in the 72 areas with decreased iodine perfusion than in the normal control areas,and the area with decreased iodine perfusion in each pulmonary lobe exhibited less iodine content as compared with the normal control area(all P<0.05).Conclusion By comparison with common CTPA,energy-spectral CTPA can better display lung embolus,and can provide a basis for diagnosing pulmonary embolism below bronchopulmonary segments through iodine-based material determination.

关 键 词：肺栓塞 肺段以下 能谱CT 碘基物质测定 CT肺动脉造影 

分 类 号：R563.5[医药卫生—呼吸系统]