双能CT肺灌注成像与多层螺旋CT肺动脉造影联合应用对肺栓塞的诊断价值

目的：探讨双源CT双能量肺灌注成像（DEPI）与肺动脉造影（CTPA）相结合对肺栓塞患者的诊断价值。方法：对50例临床怀疑肺栓塞患者进行CT双能量肺灌注成像。采用Lung PBV软件进行数据后处理,可以得到DEPI、CTPA以及两者的融合图像。通过DEPI、CTPA及两者联合检测三种方法,对肺叶、肺段及亚段水平肺栓塞诊断结果分别进行两两比较的χ2检验,分析其结果差异有无统计学意义。结果：通过χ2检验发现,在肺叶水平,DEPI、CTPA及两者联合诊断肺栓塞结果差异均无统计学意义（P〉0.05）;在肺段及亚段水平,三种方法比较均有统计学意义（P〈0.05）,尤其在亚段水平联合诊断提高了对孤立亚段肺栓塞的检出率。结论：通过将功能性的DEPI与解剖性的CTPA相结合应用既提高了诊断肺栓塞的敏感度,又保留了较高的特异度,对早期准确诊断肺栓塞有重要作用,有助于指导临床及时治疗及预后评估。

The Clinical Value of Combination of Dual-energy CT Lung Perfusion Imaging and Multilayer Spiral CT Pulmonary Angiography in the Diagnosis of Pulmonary Embolism

Objective： To investigate the clinical value of dual energy CT lung perfusion imaging（DEPI） combined with CT pulmonary angiography（CTPA） in patients with highly suspected pulmonary embolism（PE）. Methods： Fifty subjects suspected of pulmonary embolism underwent dual-energy CT pulmonary perfusion imaging. The CTPA, DEPI, and both of fusion image were acquired using the Lung Perfusion Blood Volume（PBV） software. Through DEPI, CTPA and both combined detection of three methods, χ2 test were used for the detection of three methods on pulmonary lobe level, pulmonary segment level and sub-segment level respectively to compare the different test results and analyzed whether the statistically significant difference in the test results. Results： Analysis the χ2 test results found that DEPI, CTPA and combined detection of pulmonary embolism results showed no significant difference（P 〉 0. 05） in lung lobe level; In the pulmonary segment and sub-segment level, three methods were statistically significant（P 〈 0. 05）, especially the joint detection can improve the detection rate of isolated sub-segmental with pulmonary embolism in the sub-segment level. Conclusion： Combined DEPI and CTPA, can not only improve the sensitivity of pulmonary embolism but also keep the higher specificity. It also plays an important role in early and accurate diagnosis to help clinical treatment and estimate prognosis for pulmonary embolism.