CT肺血管造影联合双能量肺灌注成像对老年性肺栓塞治疗疗效的评估

doi:10.12117/jccmi.2019.10.001

Abstract
Figure/Table
References (19)
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To investigate the value of CT pulmonary angiography(CTPA) combined with dual-energy perfusion imaging(DEPI) for evaluation of the therapeutic efficacy in senile pulmonary embolism(PE). Methods: Thirty patients with senile PE received dual-energy CT scanning under the same scanning conditions before and after treatment. The location, number and type of embolus, low perfusion position, number and degree of lung perfusion defects, the enhancement value and relative rate of enhancement, and the number of emboli in CTPA and DEPI charts were recorded. These data before or after treatment were compared. Result: There were statistical differences between the number of emboli, pulmonary embolism evaluation, pulmonary embolism index, pulmonary perfusion defect evaluation, pulmonary perfusion defect index of pulmonary trunk (level Ⅰ), lung artery(level Ⅱ), pulmonary segmental artery(level Ⅲ), subsegmental pulmonary artery(level Ⅳ)(P<0.05), before or after treatment. There were significant differences of the number of emboli in the subsegmental pulmonary artery(level Ⅳ),pulmonary embolism(perfusion defect) evaluation, pulmonary embolism(perfusion defect) index by CTPA and DEPI(P<0.05), after treatment. There was no significant difference between RVd/LVd, enhancement value or relative rate of enhancement, before and after treatment. Conclusion: CTPA could reflect the changes of emboli before and after the PE treatment. The detection rate of emboli in subsegmental pulmonary artery could be improved by CTPA based on DEPI. The therapeutic effect of PE treatment could be accurately evaluated with the quantitative analysis method of PE correlation parameter based on the combination of CTPA and DEPI.

Key words： Pulmonary embolism Tomography, X-ray computed

Received: 12 November 2018

PACS:	Ｒ563.5
	Ｒ814.42

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	WANG Hao-ran
	XIAO Xin-guang

Cite this article:

WANG Hao-ran,XIAO Xin-guang. Therapeutic effect evaluation of senile pulmonary embolism by CT pulmonary angiography combined with dual-energy perfusion imaging[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(10): 685-689.

URL:

http://www.jccmi.com.cn/EN/10.12117/jccmi.2019.10.001 OR http://www.jccmi.com.cn/EN/Y2019/V30/I10/685

[1]Bums SK, Haramati LB. Diagnostic imaging and risk stratification of patients with acute pulmonary embolism[J]. Cardiol Rev, 2012, 20(1): 15-24.
[2]马智军，冯强，张素娟，等. 双源CT双能量肺灌注成像对肺栓塞的初步研究[J]. 中华放射学杂志，2011，45（2）：116-119.
[3]Ekaufman A, Pruzan AN, Hsu C, et al. Effect of varying computed tomography acquisition and reconstruction parameters on semi-automated clot volume quantification[J]. World J Radiol, 2018(3):24-29.
[4]杨智明，唐平，毛定彪，等. CT肺动脉造影在老年急性肺栓塞疗效评估中的价值[J]. 中华老年多器官疾病杂志，2017，16（1）：18-22.
[5]中华医学会呼吸病学分会肺栓塞与肺血管病学组. 肺血栓栓塞症诊治与预防指南[J]. 中华医学杂志，2018，98（14）：1060-1087.
[6]Matsuoka S, Hunsaker AR, Gill RR, et al. Vascular enhancement and image quality of MDCT pulmonary angiography in 400 cases: comparison of standard and low kilovoltage settings[J]. Am J Roentgenol, 2009, 192(6): 1651-1656.
[7]Lu GM, Zhao Y, Zhang LJ, et al. Dual-energy CT of the lung[J]. Am J Roentgenol, 2012, 199(5 Suppl): S40-S53.
[8]Zhang LJ, Lu GM, Mminel FG, et al. Computed tomography of acute pulmonary embolism: state-of-the-art[J]. Eur Radiol, 2015, 25(9): 2547-2557.
[9]Nikolaou K, Thieme S, Sommer W, et al. Diagnosing pulmonary embolism: new computed tomography applications[J]. J Thorac Imaging, 2010, 25(2): 151-160.
[10]Den Exter PL, Van der Hulle T, Klokt FA, et al. Advances in the diagnosis and management of acute pulmonary embolism[J]. Thromb Res, 2014, 133(Suppl 2): S10-S16.
[11]孔维芳，蒲红，陶客言，等. 双能量CT肺灌注成像诊断肺栓塞[J]. 中国医学计算机成像杂志，2015，21（3）：232-236.
[12]Tang CX, Zhang LJ, Han ZH, et al. Dual-energy CT based vascular iodine analysis improves sensitivity for peripheral pulmonary artery thrombus detection: an experimental study in canines[J]. Eur J Radiol, 2013, 82(12): 2270-2278.
[13]Konstantinides SV, Torbicki A, Agnelli G, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism[J]. Eur Heart J, 2015, 36(39): 2642-2666.
[14]Shapiro NL, Bhatt SH. Critical Review and Update on the Treatment of Acute and Chronic Pulmonary Embolism[J]. J Pharm Pract, 2016, 29(1): 35-45.
[15]Kumamaru KK, Hunsaker AR, Bedayat A, et al. Subjective assessment of right ventricle enlargement from computed tomography pulmonary angiography images[J]. Int J Cardiovasc Imaging, 2012, 28(4): 975-977.
[16]耿园园，李培秀，焦亚彬，等. 非肺栓塞灌注缺损的双源CT双能量肺灌注成像表现及原因[J]. 实用放射学杂志，2017，33（8）：1187-1190.
[17]Sueyoshi E, Tsutsui S, Hayashida T, et al. Quantification of lung perfusion blood volume(lung PBV) by dual-energy CT in patients with and without pulmonary embolism: preliminary results[J]. Eur J Radiol, 2011, 80(3): 505-509.
[18]Dogan H, Roos AD, Geleijins J, et al. The role of computed tomography in the diagnosis of acute and chronic pulmonary embolism[J]. Diagn Interv Radiol, 2015, 21(4): 307-316.
[19]Van DBN, Klok FA, Huisman MV, et al. Measurement of right and left ventricular function by ECG-synchronized CT scanning in patients with acute pulmonary embolism: usefulness for predicting short-term outcome[J]. Chest, 2011, 140(4): 1008-1015.