Department of Clinical Radiology, Ludwig Maximilians University, Klinikum Grosshadern, Marchioninistr 15, D-81377 München, Germany.
Eur J Radiol. 2012 Feb;81(2):360-5. doi: 10.1016/j.ejrad.2010.11.037. Epub 2010 Dec 23.
Aims were (1) to determine the diagnostic accuracy of Dual Energy CT (DECT) in the detection of perfusion defects and (2) to evaluate the potential of DECT to improve the sensitivity for PE.
15 patients underwent Dual Energy pulmonary CT angiography (DE CTPA) and a combination of lung perfusion SPECT/CT and ventilation scintigraphy. CTPA and DE iodine distribution maps as well as perfusion SPECT/CT and inhalation scintigrams were reviewed for pulmonary embolism (PE) diagnosis. DECT and SPECT perfusion images were assessed regarding localization and extent of perfusion defects. Diagnostic accuracy of DE iodine (perfusion) maps was determined with reference to SPECT/CT. Diagnostic accuracies for PE detection of DECT and of SPECT/CT with ventilation scintigraphy were calculated with reference to the consensus reading of all modalities.
DE CTPA had a sensitivity/specificity of 100%/100% for acute PE, while the combination of SPECT/CT and ventilation scintigraphy had a sensitivity/specificity of 85.7%/87.5%. For perfusion defects, DECT iodine maps had a sensitivity/specificity of 76.7% and 98.2%.
DECT is able to identify pulmonary perfusion defects with good accuracy. This technique may potentially enhance the diagnostic accuracy in the assessment of PE.
目的是（1）确定双能 CT（DECT）在检测灌注缺陷方面的诊断准确性，（2）评估 DECT 提高 PE 灵敏度的潜力。
15 例患者接受了双能肺动脉 CT 血管造影（DE CTPA）和肺灌注 SPECT/CT 与通气闪烁扫描的联合检查。对 CTPA 和 DE 碘分布图以及灌注 SPECT/CT 和吸入闪烁扫描进行了评估，以诊断肺栓塞（PE）。DECT 和 SPECT 灌注图像评估了灌注缺陷的定位和程度。DE 碘（灌注）图的诊断准确性通过参考 SPECT/CT 来确定。DECT 和 SPECT/CT 与通气闪烁扫描检测 PE 的诊断准确性通过参考所有模态的共识阅读来计算。
DE CTPA 对急性 PE 的敏感性/特异性为 100%/100%，而 SPECT/CT 和通气闪烁扫描的联合检查的敏感性/特异性为 85.7%/87.5%。对于灌注缺陷，DECT 碘图的敏感性/特异性为 76.7%和 98.2%。
DECT 能够准确识别肺灌注缺陷。该技术可能会提高在评估 PE 中的诊断准确性。
