Kim Dong Kyu, Jung Jae Hyeop, Kim Jin Kyem, Kim Taeho
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, 37991Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, the 90156Armed Forces Capital Hospital, Seongnam, Republic of Korea.
Acta Radiol. 2023 Apr;64(4):1410-1417. doi: 10.1177/02841851221131250. Epub 2022 Oct 9.
There was a lack of studies assessing the relationship between deep vein thrombosis (DVT) Hounsfield unit (HU) density and pulmonary thromboembolism (PTE).
To evaluate the clinical value of DVT density measured on pre- and post-contrast lower-extremity computed tomography (CT) for the prediction of PTE.
From 2017 to 2021, patients who underwent pulmonary CT angiography within one week after diagnosis of DVT on lower-extremity CT were included in this retrospective study. Then, the patients without PTE were included in "DVT group" and those with both DVT and PTE were included in the "DVT-PTE group." The DVT HU density was measured by drawing free-hand region of interests (ROIs) within the thrombus at the most proximal filling defect level. A receiver operating characteristic (ROC) analysis was used to evaluate the predictive value of DVT density for the risk of PTE.
This study included a total of 94 patients (DVT group: n=56; DVT-PTE group: m=38). DVT density was significantly higher in the DVT-PTE group than the DVT group in both pre-contrast (53.5 ± 6.2 HU vs. 44.1 ± 7.9 HU; < 0.001) and post-contrast CT (67.0 ± 8.6 HU vs. 57.1 ± 10.6 HU; < 0.001). ROC analysis revealed that the area under curve, sensitivity, and specificity for predicting the risk of PTE were 0.739, 71.1%, and 64.2%, respectively, at a DVT density cutoff of 48.2 HU on pre-contrast CT and were 0.779, 73.7%, and 69.6% at a DVT density cutoff of 61.8 HU on post-contrast CT.
The DVT density on both pre- and post-contrast CT could be a predictive factor of PTE.
缺乏评估深静脉血栓形成（DVT）的亨氏单位（HU）密度与肺血栓栓塞症（PTE）之间关系的研究。
评估在对比剂增强前后的下肢计算机断层扫描（CT）上测量的DVT密度对预测PTE的临床价值。
2017年至2021年，本回顾性研究纳入了在下肢CT诊断为DVT后一周内接受肺CT血管造影的患者。然后，无PTE的患者被纳入“DVT组”，同时患有DVT和PTE的患者被纳入“DVT-PTE组”。通过在血栓最近端充盈缺损水平徒手绘制感兴趣区（ROI）来测量DVT的HU密度。采用受试者操作特征（ROC）分析来评估DVT密度对PTE风险的预测价值。
本研究共纳入94例患者（DVT组：n = 56；DVT-PTE组：m = 38）。在对比剂增强前CT（53.5±6.2 HU对44.1±7.9 HU；<0.001）和对比剂增强后CT（67.0±8.6 HU对57.1±10.6 HU；<0.001）中，DVT-PTE组的DVT密度均显著高于DVT组。ROC分析显示，在对比剂增强前CT上，DVT密度截断值为±48.2 HU时，预测PTE风险的曲线下面积、敏感性和特异性分别为0.739、71.1%和64.2%；在对比剂增强后CT上，DVT密度截断值为61.8 HU时，分别为0.779、73.7%和69.6%。
对比剂增强前后CT上的DVT密度可能是PTE的预测因素。
