Department of Radiology, National Hospital Organization, Kanmon Medical Center, Shimonoseki, Japan.
Department of Radiology, Ube-Kohsan Central Hospital, Ube, Japan.
Acta Radiol. 2023 Aug;64(8):2401-2408. doi: 10.1177/02841851231174460. Epub 2023 May 18.
Postpartum dyspnea is commonly observed, but its cause is often unknown.
To investigate postpartum dyspnea, we compared lung iodine mapping (LIM) using dual-energy computed tomography (DECT) between postpartum women and women suspected of having pulmonary thromboembolism (PTE).
In this retrospective study, 109 women of reproductive age (50 postpartum women, 59 women unrelated to pregnancy) underwent DECT between March 2009 and August 2020. Among the postpartum women, 23 patients were excluded due to late-onset dyspnea (n=20: >48 h after delivery) or the presence of PTE (n=3). A total of 86 patients were divided into three groups (27 postpartum women [postpartum group], 19 women with PTE [PTE group], and 40 women without PTE [non-PTE group]). Quantitation was applied to a decreased LIM value (LIM; defined as <5 HU) and the relative value of LIM to whole LIM volume (%LIM). LIM defects were classified into five patterns (0 = none, 1 = wedge-shaped, 2 = reticular/liner, 3 = diffuse granular/patchy, 4 = massive defects) based on a consensus between two readers.
There were significant differences in the LIM and %LIM values among the three groups. The LIM and %LIM were largest in the PTE group, and postpartum women showed intermediate values between the non-PTE and PTE groups. Wedge-shaped defects were prominent in the PTE group, and diffuse granular/patchy defect was a typical feature in the postpartum group.
Postpartum women with dyspnea showed granular/patchy defects on DECT with a median quantitative value between the PTE and non-PTE groups.
产后呼吸困难较为常见，但病因通常不明确。
通过比较产后女性和疑似肺血栓栓塞症（PTE）患者的双能 CT 肺碘图（LIM），探讨产后呼吸困难的病因。
本回顾性研究纳入了 2009 年 3 月至 2020 年 8 月期间行双能 CT 检查的 109 例育龄期女性（50 例产后女性，59 例与妊娠无关的女性）。其中，23 例产后女性因迟发性呼吸困难（n=20：分娩后>48 h）或存在 PTE（n=3）被排除。最终，86 例患者被分为三组（产后组 27 例，PTE 组 19 例，非 PTE 组 40 例）。采用定量分析法评估 LIM 值降低（定义为<5 HU）和 LIM 与全 LIM 体积的比值（%LIM）。根据两位阅片者的共识，将 LIM 缺损分为五种模式（0=无，1=楔形，2=网状/线状，3=弥漫性颗粒状/斑片状，4=大片状缺损）。
三组患者的 LIM 和 %LIM 值存在显著差异。PTE 组的 LIM 和 %LIM 值最大，产后组的 LIM 和 %LIM 值位于非 PTE 组和 PTE 组之间。PTE 组以楔形缺损为主，产后组以弥漫性颗粒状/斑片状缺损为特征。
产后呼吸困难患者的 DECT 表现为弥漫性颗粒状/斑片状缺损，定量值位于 PTE 组和非 PTE 组之间。
