Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China.
Eur Radiol. 2013 Oct;23(10):2666-75. doi: 10.1007/s00330-013-2907-x. Epub 2013 Jun 13.
To evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE).
This study was institutional review board-approved and written informed consent was obtained from each patient. Thirty-two subjects (aged 11-61 years) underwent combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT. Ventilation, perfusion and morphological information were visually interpreted. Ventilation/perfusion information was classified as mismatch (differing patterns) or match (concordant patterns). Adverse reactions and radiation doses were recorded for each subject.
Of 32 patients undergoing xenon-enhanced DECT, six patients reported adverse reactions (shortness of breath, n = 2; mild dizziness, n = 3; limb numbness, n = 1). Twenty-eight of 32 patients could be included into the data analysis. PE was detected in 10/28 patients. PE-related ventilation/perfusion mismatch was found in 17 lung lobes in 8/10 patients and matched ventilation/perfusion was detected in 2 patients. Eighteen patients had no PE. In this group, there was no case of a ventilation/perfusion mismatch. Matched ventilation/perfusion impairment was seen in one patient. The overall radiation dose from two DECT acquisitions was 4.8 ± 1.4 mSv (range 2.7-7.5 mSv).
DECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/perfusion match or mismatch in patients with suspected PE.
• Combined dual-energy CT lung ventilation/perfusion imaging is feasible. • Combined dual-energy CT ventilation/perfusion imaging provides lung morphological and functional information. • Dual-energy CT can demonstrate ventilation/perfusion mismatch in patients with pulmonary embolism.
评估疑似肺栓塞（PE）患者联合应用双能 CT（DECT）肺通气/灌注成像的可行性和结果。
本研究获得机构审查委员会批准，并获得每位患者的书面知情同意。32 例患者（年龄 11-61 岁）接受了氙增强通气和碘增强灌注 DECT 检查。通过视觉解读通气、灌注和形态学信息。将通气/灌注信息分为不匹配（不同模式）或匹配（一致模式）。记录每位患者的不良反应和辐射剂量。
在 32 例行氙增强 DECT 的患者中，有 6 例患者出现不良反应（呼吸急促，n=2；轻度头晕，n=3；肢体麻木，n=1）。32 例患者中有 28 例可纳入数据分析。28 例患者中 10 例发现 PE。10 例患者中有 8 例发现 17 个肺叶存在与 PE 相关的通气/灌注不匹配，2 例患者发现匹配通气/灌注。18 例患者无 PE，在这一组中，无一例出现通气/灌注不匹配。1 例患者出现匹配通气/灌注受损。两次 DECT 采集的总辐射剂量为 4.8±1.4 mSv（范围 2.7-7.5 mSv）。
DECT 肺通气/灌注成像可行，可在疑似 PE 患者中显示通气/灌注匹配或不匹配。
• 联合双能 CT 肺通气/灌注成像可行。
• 联合双能 CT 通气/灌注成像提供肺部形态和功能信息。
• 双能 CT 可显示肺栓塞患者通气/灌注不匹配。
