宝石能谱CT成像检查在肺栓塞临床诊断中的应用价值及影像指标分析  

The application value and imaging index analysis of gemstone energy spectrum CT imaging in the clinical diagnosis of pulmonary embolism

作　　者：赵兴永 ZHAO Xingyong(Department of Radiology,Jinan Integrated Traditional Chinese and Western Medicine Hospital,Jinan,Shandong 271100,China)

机构地区：[1]济南市中西医结合医院放射科,山东济南271100

出　　处：《影像研究与医学应用》2024年第2期34-36,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:分析宝石能谱CT成像检查诊断肺栓塞的价值及影像指标。方法:选取2021年5月—2023年5月济南市中西医结合医院收治的113例疑似肺栓塞患者,均接受宝石能谱CT成像检查,以CT肺动脉造影(CTPA)为诊断“金标准”,分析宝石能谱CT成像诊断肺栓塞的效能。结果:113例疑似肺栓塞患者中,CTPA共检出69例肺栓塞,宝石能谱CT成像共检出67例;宝石能谱CT成像诊断肺栓塞的灵敏度为94.20%、特异度为95.45%、准确率为94.69%、阳性预测值为97.01%、阴性预测值为91.30%;Kappa检验显示:宝石能谱CT成像与“金标准”的一致性极好(Kappa值=0.889);69例肺栓塞患者中,CTPA共检出149个栓子,其中85个完全型,64个不完全性(32个偏心型,20个中心型,12个附壁型),完全型、偏心型、中心型栓子栓塞区碘基值分别为(6.53±1.21)100μg/cm^(3)、(10.62±2.18)100μg/cm^(3)、(10.54±2.03)100μg/cm^(3),低于对照区的(16.35±2.49)100μg/cm^(3)、(14.53±2.01)100μg/cm^(3)、(12.69±2.36)100μg/cm^(3)(P<0.05);而附壁型栓子碘基值在对照区、栓塞区相当(P>0.05)。结论:宝石能谱CT成像可有效诊断出肺栓塞,诊断灵敏度、特异度较高,具有一定的诊断价值,临床可推广运用。Objective To analyze the value and imaging index of gemstone energy spectrum CT imaging in the diagnosis of pulmonary embolism.Methods A total of 113 suspected patients with pulmonary embolism admitted to Jinan Hospital of Integrated Traditional Chinese and Western Medicine from May 2021 to May 2023 were selected to receive gemstone energy spectrum CT imaging.Using CT pulmonary angiography(CTPA)as the diagnostic"gold standard",the efficacy of gemstone energy spectrum CT imaging in diagnosing pulmonary embolism was analyzed.Results Among 113 suspected patients with pulmonary embolism,69 cases were detected by CTPA and 67 cases were detected by gemstone energy spectrum CT imaging.The sensitivity,specificity,accuracy,positive predictive value,positive predictive value and negative predictive value were 94.20%,95.45%,94.69%,97.01%and 91.30%respectively.Kappa test showed that energy spectrum CT imaging of gemstones was in good agreement with"gold standard"(Kappa value=0.889).In 69 patients with pulmonary embolism,149 emboli were detected by the CTPA,of which 85 were complete and 64 were incomplete(32 were eccentric,20 were central,12 were mastic).The iodine group values in the embolic zone of complete,eccentric and central emboli were(6.53±1.21)100μg/cm^(3),(10.62±2.18)100μg/cm^(3),and(10.54±2.03)100μg/cm^(3),respectively.It was lower than the control area(16.35±2.49)100μg/cm^(3),(14.53±2.01)100μg/cm^(3),(12.69±2.36)100μg/cm^(3)(P<0.05);The iodine-group values of the wall attachment emboli were similar in the control and embolic areas(P>0.05).Conclusion Gemstone energy spectrum CT imaging can effectively diagnose pulmonary embolism with higher diagnostic sensitivity and specificity,and has certain diagnostic value.It can be widely applied in clinical practice.

关 键 词：肺栓塞 宝石能谱CT成像 灵敏度 特异度 

分 类 号：R445.3[医药卫生—影像医学与核医学]