Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences.
Department of Radiology, Nagasaki University School of Medicine, Nagasaki, Japan.
J Thorac Imaging. 2022 Jul 1;37(4):239-245. doi: 10.1097/RTI.0000000000000646. Epub 2022 Apr 11.
To evaluate quantified iodine mapping parameters in dual-energy computed tomography in normal patients versus those with chronic thromboembolic pulmonary hypertension (CTEPH) with and without pulmonary thromboembolism.
Using automatically quantified iodine mapping in dual-energy computed tomography, we evaluated lung relative average enhancement, standard deviation (SD), and the SD/lung relative average enhancement ratio. We compared the values for these parameters in normal patients versus those with CTEPH. We also performed a receiver operating characteristic curve analysis to determine the diagnostic cutoffs for the parameters.
Patients constituted 41 patients (10 male [24.4%] and 31 female [75.6%]; mean age [SD]: 70.0 y [13.3]) with CTEPH and 237 (92 male [38.8%] and 145 female [61.2%]; mean age [SD]: 65.9 y [15.9]) normal patients. We found significant differences in lung relative average enhancement (34.9±6.3 vs. 26.9±6.3; P <0.0001), SD (11.6±1.9 vs. 14.7±3.3; P <0.001), and the SD/lung relative average enhancement ratio (33.7±5.0 vs. 55.7±10.4; P <0.001) between the normal and CTEPH groups, respectively. The ROC analyses demonstrated high discriminatory power (area under the curve=0.99) for using the SD/lung relative average enhancement ratio to differentiate between patients in the normal group and CTEPH group. At a threshold for the area under the curve of 44.2, diagnostic sensitivity, specificity, positive predictive value, and negative predictive value for the ratio were 92.7%, 97.5%, 86.5%, and 98.7%, respectively.
Patients with CTEPH were well-discriminated from normal patients using the SD/lung relative average enhancement ratio.
利用双能 CT 自动碘图定量分析参数，评估正常患者与伴有和不伴有肺动脉血栓栓塞的慢性血栓栓塞性肺动脉高压（CTEPH）患者之间的差异。
采用双能 CT 自动碘图定量分析，评估肺相对平均增强值、标准偏差（SD）和 SD/肺相对平均增强值的比值。比较正常患者与 CTEPH 患者之间这些参数的差异。同时进行受试者工作特征曲线（ROC）分析，以确定这些参数的诊断截断值。
共纳入 41 例 CTEPH 患者（男 10 例[24.4%]，女 31 例[75.6%]；平均年龄[标准差]：70.0±13.3 岁）和 237 例正常患者（男 92 例[38.8%]，女 145 例[61.2%]；平均年龄[标准差]：65.9±15.9 岁）。我们发现肺相对平均增强值（34.9±6.3 比 26.9±6.3；P＜0.0001）、SD（11.6±1.9 比 14.7±3.3；P＜0.001）和 SD/肺相对平均增强值的比值（33.7±5.0 比 55.7±10.4；P＜0.001）在正常组和 CTEPH 组之间存在显著差异。ROC 分析表明，SD/肺相对平均增强值比值对区分正常组和 CTEPH 组患者具有较高的鉴别能力（曲线下面积=0.99）。当曲线下面积的阈值为 44.2 时，该比值的诊断敏感度、特异度、阳性预测值和阴性预测值分别为 92.7%、97.5%、86.5%和 98.7%。
SD/肺相对平均增强值比值可较好地区分 CTEPH 患者与正常患者。
