肺双能CT灌注血容量作为慢性血栓栓塞性肺动脉高压严重程度的标志物

Lung Dual-Energy CT Perfusion Blood Volume as a Marker of Severity in Chronic Thromboembolic Pulmonary Hypertension.

作者信息

Si-Mohamed Salim A, Zumbihl Léa, Turquier Ségolène, Boccalini Sara, Mornex Jean-Francois, Douek Philippe, Cottin Vincent, Boussel Loic

机构信息

Radiology Department, Louis Pradel Hospital, 59 Boulevard Pinel, 69500 Bron, France.

INSA-Lyon, University of Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Lyon, France.

出版信息

Diagnostics (Basel). 2023 Feb 17;13(4):769. doi: 10.3390/diagnostics13040769.

In chronic thromboembolic pulmonary hypertension (CTEPH), assessment of severity requires right heart catheterization (RHC) through cardiac index (CI). Previous studies have shown that dual-energy CT allows a quantitative assessment of the lung perfusion blood volume (PBV). Therefore, the objective was to evaluate the quantitative PBV as a marker of severity in CTEPH. In the present study, thirty-three patients with CTEPH (22 women, 68.2 ± 14.8 years) were included from May 2017 to September 2021. Mean quantitative PBV was 7.6% ± 3.1 and correlated with CI (r = 0.519, = 0.002). Mean qualitative PBV was 41.1 ± 13.4 and did not correlate with CI. Quantitative PBV AUC values were 0.795 (95% CI: 0.637-0.953, = 0.013) for a CI ≥ 2 L/min/m and 0.752 (95% CI: 0.575-0.929, = 0.020) for a CI ≥ 2.5 L/min/m. In conclusion, quantitative lung PBV outperformed qualitative PBV for its correlation with the cardiac index and may be used as a non-invasive marker of severity in CTPEH patients.

在慢性血栓栓塞性肺动脉高压（CTEPH）中，严重程度的评估需要通过心脏指数（CI）进行右心导管检查（RHC）。先前的研究表明，双能CT可对肺灌注血容量（PBV）进行定量评估。因此，本研究的目的是评估定量PBV作为CTEPH严重程度的标志物。在本研究中，纳入了2017年5月至2021年9月期间的33例CTEPH患者（22例女性，年龄68.2±14.8岁）。平均定量PBV为7.6%±3.1，与CI相关（r = 0.519，P = 0.002）。平均定性PBV为41.1±13.4，与CI不相关。对于CI≥2 L/min/m²，定量PBV的AUC值为0.795（95%CI：0.637 - 0.953，P = 0.013）；对于CI≥2.5 L/min/m²，定量PBV的AUC值为0.752（95%CI：0.575 - 0.929，P = 0.020）。总之，定量肺PBV与心脏指数的相关性优于定性PBV，可作为CTPEH患者严重程度的非侵入性标志物。