闭塞性与非闭塞性肺栓塞双源CT双能量肺灌注成像的初步研究

发布时间：2018-03-22 00:31

本文选题：肺栓塞　切入点：体层摄影术　出处：《放射学实践》2017年11期 　论文类型：期刊论文

【摘要】：目的:探讨急性肺栓塞(PE)患者双源CT肺动脉成像(CTPA)显示的闭塞性与非闭塞性栓子在双源CT双能量肺灌注成像(DEPI)的视觉分析法及半定量分析的初步研究。方法:搜集本院2015年6月-2017年1月经CTPA及DEPI扫描确诊的31例急性PE患者的病例资料。分析CTPA,记录PE栓子的数量、分布部位及栓塞类型。分析DEPI,分别计算每个栓子栓塞区与对照区肺组织灌注CT值的差值(△CT值)。结果:将CTPA所示栓子按其分布部位及栓塞程度分为四型:中央型闭塞型、中央型非闭塞型、周围型闭塞型、周围型非闭塞型。DEPI视觉分析法:闭塞型组中,表现为灌注减低、灌注轻度减低、灌注不变的比例为78.57%(99/126)、21.43%(27/126)、0.00%(0/126)。非闭塞组中,其比例分别为19.70%(26/132)、34.09%(45/132)、46.21%(61/132)。中央型闭塞型、中央型非闭塞型、周围型闭塞型、周围型非闭塞型视觉阳性率分别为100.00%(85/85)、66.11%(66/108)、100.00%(41/41)、20.83%(5/24)。DEPI半定量分析:闭塞型与非闭塞型间差异具有统计学意义[(64.59±12.10)HU vs(33.12±9.72)HU,t=22.968,P0.01];中央型闭塞型与中央型非闭塞型、周围型闭塞型与周围型非闭塞型间差异均具有统计学意义[分别为(70.12±13.55)HU vs(36.23±7.87)HU,t=20.506,P0.01;(53.12±14.64)HU vs(19.12±5.77)HU,t=13.220,P0.01]。结论:闭塞型栓子往往引起灌注异常,而非闭塞型栓子,受多种因素影响,DEPI呈现多样化。双源CTPA联合DEPI视觉分析及半定量分析能够对PE治疗前评估提供更加全面、客观的依据。
[Abstract]:Objective: to investigate the visual analysis and semi-quantitative analysis of dual source CT pulmonary artery imaging (CTPA) and non occlusive embolus in dual source CT dual energy pulmonary perfusion imaging (DEPI) in patients with acute pulmonary embolism (PEE). Methods:. The data of 31 patients with acute PE diagnosed by CTPA and DEPI from June 2015 to January 2017 were analyzed and the number of PE emboli was recorded. Distribution location and embolism type. The difference of CT value of pulmonary perfusion in each embolus embolism area and control area was calculated. Results: according to the location and degree of embolism, the embolus was classified into four types: central occlusive type, central occlusive type, and central occlusion type. Central type, peripheral type, peripheral type, non-occlusive type .DEPI visual analysis: in the occlusion group, the perfusion was decreased, the perfusion was slightly decreased, and the proportion of perfusion was invariant was 78.57%, the ratio was 78.57%, the ratio was 78.57%, and the ratio was 78.57%, 126%, 21.43%, 27%, 126%, 0.000% 126%, and 0.000% 126%, in the non-occlusive group, The ratios are 19.70 / 132 / 34.09 / 45 / 132 / 46.21, respectively. The central type is closed type, the central type is non-occlusive type, the peripheral type is occlusive type, the central type is closed type, the central type is non-occlusive type, and the peripheral type is occlusive type. The visual positive rate of peripheral non-occlusive type was 100.00-85 / 85 / 66.11and 66 / 108 / 100.005 / 41 / 20.83% respectively. The difference between occlusive type and non-occlusive type was statistically significant [64.59 卤12.10)HU vs(33.12 卤9.72HUT 22.968 P0.01]; central occlusion type and central non-occlusive type were not occluded type, and there was a significant difference between them [64.59 卤12.10)HU vs(33.12 卤9.72HUT 22.968 P0.01]. There were significant differences between peripheral occlusion type and peripheral type non-occlusive type [70.12 卤13.55)HU vs(36.23 卤7.87 vs(36.23 卤7.87 vs(36.23 卤7.87 vs(36.23 卤7.87]. Conclusion: occlusive emboli often cause abnormal perfusion, but non-occlusive thromboemboli, 53.12 卤14.64)HU vs(19.12 卤5.77 Hut 13.220 P0.01, respectively. Dual-source CTPA combined with DEPI visual analysis and semi-quantitative analysis can provide a more comprehensive and objective basis for evaluation of PE before treatment.
【作者单位】：中国石油天然气集团公司中心医院影像科;
【分类号】：R563.5;R816.4

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