双源CT双能量肺动脉成像结合灌注血池容积技术评价急性肺栓塞的初步研究

发布时间：2018-11-02 15:19

【摘要】：目的探讨双源CT双能量肺动脉成像结合灌注血池容积(PBV)技术评价急性肺栓塞的诊断价值。方法对48例临床诊断肺栓塞患者进行CT肺动脉造影(CTPA)及PBV成像,所得图像以肺叶及肺段为评价单位,分别对CTPA血管内栓子数量及栓塞程度,PBV灌注缺损区平均CT值及碘含量值进行统计,分析其相关性。结果48例患者除3例有不同程度支气管炎、肺气肿、肺间质纤维化或胸腔积液,双肺表现为弥漫灌注降低,未纳入统计;其余共有225个肺叶和肺叶动脉,720个肺段和肺段动脉纳入分析。其中78个肺叶、171个肺段内有栓子存在。以肺叶为评价单位,PBV共检出灌注缺损或降低75个,CTPA检出相应的血管栓塞78个,符合率为96.2%;以肺段为评价单位,PBV共检出156个肺段有灌注缺损或降低,与CTPA检出171个栓子的符合率为91.2%,病变区域的PBV图(包括CT值及碘含量)与肺栓塞的有无及栓塞的程度存在显著统计学差异。结论双源CT双能量肺动脉成像结合PBV技术有助于提高对急性肺栓塞的诊断正确率。
[Abstract]:Objective to evaluate the diagnostic value of dual source CT dual energy pulmonary angiography combined with perfusion blood pool volume (PBV) in the diagnosis of acute pulmonary embolism. Methods CT pulmonary angiography (CTPA) and PBV imaging were performed in 48 patients with pulmonary embolism. The pulmonary lobe and lung segments were used as evaluation units. The number of embolism and the degree of embolism in CTPA were evaluated. The average CT value and iodine content in PBV perfusion defect area were analyzed and the correlation was analyzed. Results except for 3 cases with bronchitis, emphysema, interstitial fibrosis or pleural effusion, 48 cases showed decreased diffuse perfusion, which was not included in the statistics. There were 225 lobar and lobar arteries, 720 segmental and segmental arteries. Among them, 78 lobes and 171 segments had embolus. Using pulmonary lobes as evaluation unit, 75 cases of perfusion defect or reduction were detected by PBV and 78 cases of vascular embolism were detected by CTPA. Using lung segment as the evaluation unit, 156 lung segments were detected by PBV with perfusion defect or decrease, and the coincidence rate with 171 emboli detected by CTPA was 91.2%. There was significant difference between PBV (including CT value and iodine content) and the degree of pulmonary embolism (PE). Conclusion dual source CT dual energy pulmonary artery imaging combined with PBV technique is helpful to improve the diagnostic accuracy of acute pulmonary embolism.
【作者单位】：浙江大学附属第一医院放射科;杭州市第一人民医院;
【基金】：杭州市卫生局课题(编号:2013A13)
【分类号】：R563.5

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