中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
9期
926-930
,共5页
黄小勇%濮欣%张兆琪%窦瑞雨%晏子旭%肖金利%姜红%刘一%铁红红%米宏志
黃小勇%濮訢%張兆琪%竇瑞雨%晏子旭%肖金利%薑紅%劉一%鐵紅紅%米宏誌
황소용%복흔%장조기%두서우%안자욱%초금리%강홍%류일%철홍홍%미굉지
肺栓塞%体层摄影术,X线计算机%灌流%放射性核素显像
肺栓塞%體層攝影術,X線計算機%灌流%放射性覈素顯像
폐전새%체층섭영술,X선계산궤%관류%방사성핵소현상
Pulmonary embolism%Tomography,X-ray computed%Perfusion%Radionuclide imaging
目的 通过与核素肺通气灌注显像比较,评价双能量CT肺血管成像(DE-CTPA)及双能量CT肺灌注成像(DE-CTLP)技术诊断肺栓塞的能力.方法 比较50例临床怀疑肺栓塞的患者DE-CTPA、DE-CTLP及核素肺通气灌注显像结果,以非线性相关检验比较DE-CTPA显示肺血管腔内充盈缺损与DE-CTLP显示灌注缺损之间的相关性,以核素为参考标准,应用一致性检验方法(Kappa检验)对照分析两者之间的一致性及DE-CTLP诊断肺栓塞的敏感性和特异性.结果 (1)50例临床怀疑肺栓塞患者中,4例CT图像质量差,不能评价.余46例共920个有效肺段中,DE-CTPA显示262个肺段肺血管腔内充盈缺损,DE-CTLP显示266个肺段明确灌注缺损.核素肺通气灌注扫描显示268个肺段灌注与通气不匹配.(2)DE-CTLP与DE-CTPA两者间显著相关(r=0.883,P<0.01);DE-CTLP与核素肺通气灌注显像的一致性良好(Kappa=0.940,P<0.01);以核素肺通气灌注成像为诊断参考标准,应用DE-CTLP诊断肺栓塞的阳性预测值95.5%(279/292),阴性预测值98.3%(641/652),敏感性96.2%(279/290),特异性98.0%(641/654).(3)应用CareDose 4D技术,DE-CTPA和DE-CTLP患者平均射线损伤剂量为(4.37±0.47)mSv.结论 应用DE-CTPA和DE-CTLP技术可以在一次扫描中同时获得常规CT肺血管成像的血管形态学信息和肺实质血流灌注情况,为临床诊断肺栓塞提供直观、有效的综合影像信息.
目的 通過與覈素肺通氣灌註顯像比較,評價雙能量CT肺血管成像(DE-CTPA)及雙能量CT肺灌註成像(DE-CTLP)技術診斷肺栓塞的能力.方法 比較50例臨床懷疑肺栓塞的患者DE-CTPA、DE-CTLP及覈素肺通氣灌註顯像結果,以非線性相關檢驗比較DE-CTPA顯示肺血管腔內充盈缺損與DE-CTLP顯示灌註缺損之間的相關性,以覈素為參攷標準,應用一緻性檢驗方法(Kappa檢驗)對照分析兩者之間的一緻性及DE-CTLP診斷肺栓塞的敏感性和特異性.結果 (1)50例臨床懷疑肺栓塞患者中,4例CT圖像質量差,不能評價.餘46例共920箇有效肺段中,DE-CTPA顯示262箇肺段肺血管腔內充盈缺損,DE-CTLP顯示266箇肺段明確灌註缺損.覈素肺通氣灌註掃描顯示268箇肺段灌註與通氣不匹配.(2)DE-CTLP與DE-CTPA兩者間顯著相關(r=0.883,P<0.01);DE-CTLP與覈素肺通氣灌註顯像的一緻性良好(Kappa=0.940,P<0.01);以覈素肺通氣灌註成像為診斷參攷標準,應用DE-CTLP診斷肺栓塞的暘性預測值95.5%(279/292),陰性預測值98.3%(641/652),敏感性96.2%(279/290),特異性98.0%(641/654).(3)應用CareDose 4D技術,DE-CTPA和DE-CTLP患者平均射線損傷劑量為(4.37±0.47)mSv.結論 應用DE-CTPA和DE-CTLP技術可以在一次掃描中同時穫得常規CT肺血管成像的血管形態學信息和肺實質血流灌註情況,為臨床診斷肺栓塞提供直觀、有效的綜閤影像信息.
목적 통과여핵소폐통기관주현상비교,평개쌍능량CT폐혈관성상(DE-CTPA)급쌍능량CT폐관주성상(DE-CTLP)기술진단폐전새적능력.방법 비교50례림상부의폐전새적환자DE-CTPA、DE-CTLP급핵소폐통기관주현상결과,이비선성상관검험비교DE-CTPA현시폐혈관강내충영결손여DE-CTLP현시관주결손지간적상관성,이핵소위삼고표준,응용일치성검험방법(Kappa검험)대조분석량자지간적일치성급DE-CTLP진단폐전새적민감성화특이성.결과 (1)50례림상부의폐전새환자중,4례CT도상질량차,불능평개.여46례공920개유효폐단중,DE-CTPA현시262개폐단폐혈관강내충영결손,DE-CTLP현시266개폐단명학관주결손.핵소폐통기관주소묘현시268개폐단관주여통기불필배.(2)DE-CTLP여DE-CTPA량자간현저상관(r=0.883,P<0.01);DE-CTLP여핵소폐통기관주현상적일치성량호(Kappa=0.940,P<0.01);이핵소폐통기관주성상위진단삼고표준,응용DE-CTLP진단폐전새적양성예측치95.5%(279/292),음성예측치98.3%(641/652),민감성96.2%(279/290),특이성98.0%(641/654).(3)응용CareDose 4D기술,DE-CTPA화DE-CTLP환자평균사선손상제량위(4.37±0.47)mSv.결론 응용DE-CTPA화DE-CTLP기술가이재일차소묘중동시획득상규CT폐혈관성상적혈관형태학신식화폐실질혈류관주정황,위림상진단폐전새제공직관、유효적종합영상신식.
Objective To investigate the diagnostic value of dual-energy CT pulmonary angiography (DE-CTPA) and dual-energy CT lung perfusion (DE-CTLP) in the assessment of pulmonary embolism comparing with pulmonary ventilation-perfusion scintigraphy. Methods Fifty patients suspected of PE (26 males, 24 females) underwent both DE-CTPA, DE-CTLP and pulmonary ventilation-perfusion scintigraphy. The results were compared and the correlation between the intravascular clots in DE-CTPA and the perfusion defects in DE-CTLP was analyzed. The sensitivity, specificity and accuracy of DE-CTLP for PE were assessed according to scintigraphic results which was considered as a "gold" standard. Result ( 1 ) Of 50 cases,920 segments in 46 cases were diagnostable, 4 cases were not included because of the poor image quality. lntravascular clots were found in 262 segments on DE-CTPA and perfusion defects in 266 segments were identified on DE-CTLP, while 268 segments were positive on scintigraphy. (2) The perfusion defects on DE-CTLP were correlated well with the clots on CTPA ( r = 0. 883, P < 0. 01 ). The Dual energy CT Lung perfusion imaging had a good consistence with scintigraphy (Kappa = 0. 940, P <0. 01 ). The sensitivity, specificity, positive and negative predictive value were 96. 2% (279/290), 98.0%(641/654), 95. 5% (279/292) and 98. 3% (641/652), respectively. (3)The radiation dose of DE-CTPA and CE-CTLP scan was(4. 37 ± 0. 47) mSv by using CareDose 4D technique. Conclusion DE-CTPA and CE-CTLP can provide pulmonary vascular morphology and parenchyma perfusion information which are useful and valuable for the diagnosis of PE.
