Scialpi Michele, Rebonato Alberto, Cagini Lucio, Brunese Luca, Piscioli Irene, Pierotti Luisa, Bellantonio Lucio, D'Andrea Alfredo, Rotondo Antonio
Department of Surgical and Biomedical Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy.
Department of Surgical and Biomedical Sciences, Thoracic Surgery, Perugia University, S. Maria dellaMisericordia Hospital, Perugia, Italy.
Iran J Radiol. 2016 Jan 14;13(1):e19844. doi: 10.5812/iranjradiol.19844. eCollection 2016 Jan.
Currently computed tomography pulmonary angiography (CTPA) has become a widely accepted clinical tool in the diagnosis of acute pulmonary embolism (PE).
To report split-bolus single-pass 64-multidetector-row CT (MDCT) protocol for diagnosis of PE.
MDCT split-bolus results in 40 patients suspicious of PE were analyzed in terms of image quality of target pulmonary vessels (TPVs) and occurrence and severity of flow-related artifact, flow-related artifact, false filling defect of the pulmonary veins and beam hardening streak artifacts. Dose radiation to patients was calculated.
MDCT split-bolus protocol allowed diagnostic images of high quality in all cases. Diagnosis of PE was obtained in 22 of 40 patients. Mean attenuation for target vessels was higher than 250 HU all cases: 361 ± 98 HU in pulmonary artery trunk (PAT); 339 ± 93 HU in right pulmonary artery (RPA); 334 ± 100 HU in left pulmonary artery (LPA). Adequate enhancement was obtained in the right atrium (RA):292 ± 83 HU; right pulmonary vein (RPV): 302 ± 91 HU, and left pulmonary vein (LPV): 291 ± 83 HU. The flow related artifacts and the beam hardening streak artifacts have been detected respectively in 4 and 25 patients. No false filling defect of the pulmonary veins was revealed.
MDCT split-bolus technique by simultaneous opacification of pulmonary arteries and veins represents an accurate technique for diagnosis of acute PE, removes the false filling defects of the pulmonary veins, and reduces flow related artifacts.
目前，计算机断层扫描肺动脉造影（CTPA）已成为诊断急性肺栓塞（PE）广泛接受的临床工具。
报告用于诊断PE的分剂量单期64排多层螺旋CT（MDCT）方案。
分析了40例疑似PE患者的MDCT分剂量结果，包括目标肺血管（TPV）的图像质量、血流相关伪影的发生及严重程度、血流相关伪影、肺静脉的假充盈缺损以及线束硬化条纹伪影。计算了患者的辐射剂量。
MDCT分剂量方案在所有病例中均能获得高质量的诊断图像。40例患者中有22例确诊为PE。所有病例中目标血管的平均衰减均高于250 HU：肺动脉主干（PAT）为361±98 HU；右肺动脉（RPA）为339±93 HU；左肺动脉（LPA）为334±100 HU。右心房（RA）获得了足够的强化：292±83 HU；右肺静脉（RPV）：302±91 HU，左肺静脉（LPV）：291±83 HU。分别在4例和25例患者中检测到血流相关伪影和线束硬化条纹伪影。未发现肺静脉的假充盈缺损。
MDCT分剂量技术通过同时使肺动脉和肺静脉显影，是诊断急性PE的一种准确技术，消除了肺静脉的假充盈缺损，并减少了血流相关伪影。
