双能量CT肺灌注成像定量参数在肺栓塞诊断、危险分层及溶栓治疗效果评估中的应用价值  

The value of quantitative parameters of dual energy CT pulmonary perfusion imaging in the diagnosis,risk stratification,and ffievaluation of thrombolytic therapy efficacy in pulmonary embolism

作　　者：曹立芝 滕云 CAO Lizhi;TENG Yun(Department of Imaging,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影像科,山东济南271100

出　　处：《影像研究与医学应用》2025年第7期32-34,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:探析双能量CT肺灌注成像定量参数在肺栓塞诊断、危险分层及溶栓治疗效果评估中的价值。方法:选择2023年1月—2024年1月济南市中西医结合医院经双能量CT肺灌注成像检查的61例肺栓塞患者和17例无肺栓塞患者分别纳入肺栓塞组和无肺栓塞组,比较两组的CT肺灌注成像定量参数,并分析其在肺栓塞诊断中的作用。将肺栓塞患者进一步分为中高危组(33例)和低危组(28例),比较两组的定量参数差异。对接受溶栓治疗的25例患者进行随访,比较治疗有效与无效患者的定量参数变化。结果:确诊肺栓塞组的肺血管阻塞指数(PVOI)和肺灌注缺损指数(PPDI)高于无肺栓塞组,中高危组的PVOI和PPDI高于低危组,溶栓治疗有效组的PVOI和PPDI低于溶栓治疗无效组,差异有统计学意义(P<0.05)。绘制受试者工作特征曲线发现,双能量CT肺灌注成像定量参数PVOI和PPDI在肺栓塞诊断中的AUC分别为0.850、0.890,均有一定的诊断价值,且联合检测的价值更高。结论:双能量CT肺灌注成像是一种无创且快捷的检查手段,在肺栓塞早期诊断、风险评估及疗效监测方面具有重要意义。Objective To explore the value of quantitative parameters of dual energy CT(DECT)pulmonary perfusion imaging(PPI)in the diagnosis,risk stratifification,and evaluation of thrombolytic therapy effifficacy in pulmonary embolism.Methods A total of 61 patients with pulmonary embolism and 17 patients without pulmonary embolism from Jinan Integrated Traditional Chinese and Western Medicine Hospital who underwent DECT PPI from January 2023 to January 2024 were selected to be included in the two groups,and the quantitative parameters of DECT PPI in the two groups were compared to analyze the value of DECT PPI quantitative parameters in the diagnosis of pulmonary embolism.61 patients with pulmonary embolism were divided into medium-high risk group(33 cases)and lowrisk group(28 cases).The quantitative parameters of DECT PPI were compared between the two groups.25 patients who underwent thrombolytic therapy were followed up to compare the quantitative parameters of DECT PPI in effffective and ineffffective patients.Results The pulmonary vascular obstruction index(PVOI)and pulmonary perfusion defect index(PPDI)in the confifirmed pulmonary embolism group were higher than those in the no pulmonary embolism group,those in the medium-high risk group were higher than those in the low-risk group,and those in the effffective thrombolytic therapy group were lower than those in the ineffffective thrombolytic therapy group,with statistical signifificance(P<0.05).The receiver operating characteristic curve showed that the AUC of PVOI and PPDI quantitative parameters in the diagnosis of pulmonary embolism were 0.850 and 0.890,respectively,both of which had certain diagnostic value,and the value of combined detection was higher.Conclusion DECT PPI,as a non-invasive and rapid examination method,can play an important role in the early diagnosis,risk stratifification,and therapy effifficacy evaluation of pulmonary embolism.

关 键 词：肺栓塞 危险分层 溶栓 双能量CT 肺灌注成像 

分 类 号：R445.3[医药卫生—影像医学与核医学]