摘要
目的：探讨西门子第二代双源CT（Somatom Definition Flash）双能量成像对肺动脉栓塞的诊断价值。方法：回顾性研究42位临床疑诊肺栓塞行双能量肺血管成像（DE-CTPA）扫描的患者的资料，利用工作站双能量软件Lung PBV（肺灌注）、Lung Vessels（肺血管）进行彩色编码成像。2名胸部影像医师结合DE-CTPA与软件提供的信息做出诊断。结果：根据临床及CT结果，其中32例（76.2%，32/42）存在肺动脉栓塞，28例在CTPA上表现为肺动脉充盈缺损， 4例在CTPA上未见异常征象，而双能量成像上表现为亚段或以下水平灌注或充盈缺损。双能量Lung PBV测得32例48个栓塞肺区CT强化值（35.6±12.1） HU，低于非栓塞区域所测得的CT强化值（44.5±10.6） HU，t=-2.336，P=0.027。结论：双能量Lung PBV与Lung Vessels软件能显示肺栓塞所致的灌注及充盈缺损，结合CTPA能提高肺栓塞的检出率，特别是外周性肺动脉栓塞。
Abstract
Objective: To investigate the diagnostic value of the second-generation Siemens dual-source CT(Somatom Definition Flash) dual-energy imaging of pulmonary embolism. Methods: Dual-energy pulmonary angiography(CTPA) data of 42 patients with clinically suspected pulmonary embolism were retrospectively studied by dual-energy software on the workstation. Lung PBV(lung perfusion), Lung Vessels(pulmonary vasculature) and color-coded imaging were analyzed. Two chest-imaging physicians combined information provided by both the DE-CTPA and software to make a diagnosis. Results: According to clinical and CT findings, 32 cases(76.2%, 32/42) had pulmonary embolism, with pulmonary filling defects on CTPA in 28 cases, normal CTPA but perfusion defects in sub-segments or below on DE-CTPA in four cases. Lung PBV measured 32 cases with 48 embolism pulmonary, with a CT enhancement value of (35.6±12.1) HU, lower than the non-embolism region with a CT enhancement value of (44.5±10.6) HU(t=-2.336, P=0.027). Conclusion: Dual-energy lung perfusion(Lung PBV) and pulmonary vascular(Lung Vessels) software can display perfusion defects in pulmonary embolism. Combined with CTPA, it can improve the detection rate of pulmonary embolism, especially peripheral pulmonary embolism.
关键词
肺栓塞 /
体层摄影术 /
螺旋计算机
Key words
Pulmonary embolism /
Tomography /
spiral computed
吴 山;武志峰;鄂林宁;江小鹏.
第二代双源CT双能量成像对肺栓塞的诊断价值研究[J]. 中国临床医学影像杂志. 2012, 23(11): 782-784
WU Shan;WU Zhi-feng;E Lin-ning;JIANG Xiao-peng.
Study of new dual-source dual-energy CT pulmonary angiography for pulmonary embolism diagnosis[J]. Journal of China Clinic Medical Imaging. 2012, 23(11): 782-784
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