Hunter Joshua G, Prajapati Priyanka, Bera Kaustav, Gupta Aekta, Gupta Amit
Radiology, Case Western Reserve University School of Medicine, Cleveland, USA.
Radiology, University Hospitals Cleveland Medical Center, Cleveland, USA.
Cureus. 2023 Mar 22;15(3):e36551. doi: 10.7759/cureus.36551. eCollection 2023 Mar.
In this article, we aim to highlight the utility of dual-energy computed tomography (DECT) in demonstrating imaging changes due to hypoxic pulmonary vasoconstriction (HPV). DECT allows detailed image reconstructions that have been shown to better characterize cardiothoracic pathologies, as compared to conventional CT techniques. DECT simultaneously detects two different X-ray energies, which enables generation of iodine density maps, virtual monoenergetic images, and effective atomic number maps (Z), among others. DECT has been shown to have utility in the assessment of benign versus malignant pulmonary nodules, pulmonary embolism, myocardial perfusion defects, and other conditions. Herein, we describe four cases of indeterminate pulmonary pathology when imaged with conventional CT in which subsequent use of DECT-derived image reconstructions demonstrated HPV as the underlying pathophysiological mechanism. The goal of this article is to understand the imaging appearance of HPV on DECT and discuss how HPV may mimic other causes of perfusion defects.
在本文中，我们旨在强调双能计算机断层扫描（DECT）在显示因低氧性肺血管收缩（HPV）导致的影像学变化方面的效用。与传统CT技术相比，DECT能够进行详细的图像重建，已证明其能更好地对心胸疾病进行特征描述。DECT同时检测两种不同的X射线能量，这使得能够生成碘密度图、虚拟单能图像以及有效原子序数图（Z）等。已证明DECT在评估肺结节的良恶性、肺栓塞、心肌灌注缺损及其他病症方面具有效用。在此，我们描述了4例在常规CT成像时表现为不确定肺部病变的病例，随后使用DECT衍生的图像重建显示HPV为潜在的病理生理机制。本文的目的是了解HPV在DECT上的影像学表现，并讨论HPV如何可能模仿其他灌注缺损的原因。
