Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
Clin Imaging. 2021 Jan;69:305-310. doi: 10.1016/j.clinimag.2020.10.006. Epub 2020 Oct 6.
To evaluate the image quality of chest CT performed on dual-energy scanners using low contrast volume for routine chest (DECT-R) and pulmonary angiography (DECTPA) protocols.
This retrospective study included dual-energy CT scans of chest performed with low contrast volume in 84 adults (34M:50F; Age 69 ± 16 years: Weight 71 ± 16kg). There were 42 patients with DECT-R and 42 patients with DECT-PA protocols. Images were reviewed by two thoracic radiologists. Qualitative assessment was done on a four-point scale, for subjective assessment of contrast enhancement and artifacts (1 = Excellent, 2 = optimal, 3 = suboptimal, and 4 = Limited) in the pulmonary arteries and thoracic aorta, on virtual monoenergetic and material decomposition iodine (MDI) images. Quantitative assessment was performed by measuring the CT (Hounsfield) units in aorta and pulmonary arteries. The estimated glomerular filtration rate (eGFR) was calculated before and after CT scans. Two tailed student's t-test was performed to assess the significance of findings, and strength of correlation between readers was determined by Cohen's kappa test.
DECT-PA and DECT-R demonstrated excellent/adequate contrast density within the pulmonary arteries (up to segmental branch), and aorta. There was no suboptimal or limited examination. There was strong interobserver agreement for arterial enhancement in pulmonary arteries (kappa = 0.62-0.89) and for thoracic aorta (kappa = 0.62-0.94). Pulmonary emboli were seen in 3/42(7%) in DECT-R and in 5/42(12%) in DECT-PA. There was no significant change in eGFR before and after IV contrast injection (p = 0.46-0.52).
DECT-R and DECT-PA performed with low contrast volume provide diagnostic quality opacification of the pulmonary vessels and aorta vessels.
评估使用低对比剂体积进行常规胸部（DECT-R）和肺动脉造影（DECTPA）协议的双能扫描仪进行胸部 CT 的图像质量。
本回顾性研究纳入了 84 例成人（34 例男性，50 例女性；年龄 69±16 岁：体重 71±16kg）进行的双能 CT 扫描。其中 42 例患者行 DECT-R 协议，42 例患者行 DECTPA 协议。由两名胸部放射科医生对图像进行评估。使用 4 分制对图像进行主观评估，评估标准为肺动脉和胸主动脉的对比增强和伪影（1=优秀，2=最佳，3=次优，4=有限），评估指标包括虚拟单能量和物质分解碘（MDI）图像。通过测量主动脉和肺动脉的 CT（亨氏）单位进行定量评估。在 CT 扫描前后计算肾小球滤过率（eGFR）。使用双尾学生 t 检验评估发现的显著性，使用 Cohen's kappa 检验评估读者之间的相关性强度。
DECT-PA 和 DECT-R 在肺动脉（可达段性分支）和主动脉内显示出良好/足够的对比密度。没有次优或有限的检查。观察者之间对肺动脉（kappa=0.62-0.89）和胸主动脉（kappa=0.62-0.94）的动脉增强有很强的一致性。在 DECT-R 中，3/42（7%）的患者发现肺栓塞，在 DECT-PA 中，5/42（12%）的患者发现肺栓塞。在静脉造影剂注射前后，eGFR 没有显著变化（p=0.46-0.52）。
使用低对比剂体积进行的 DECT-R 和 DECTPA 可提供诊断质量的肺部血管和主动脉血管显影。
