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急性肺栓塞的现代影像学检查。

Modern imaging of acute pulmonary embolism.

机构信息

Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.

Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.

出版信息

Thromb Res. 2024 Jun;238:105-116. doi: 10.1016/j.thromres.2024.04.016. Epub 2024 Apr 23.

Abstract

The first-choice imaging test for visualization of thromboemboli in the pulmonary vasculature in patients with suspected acute pulmonary embolism (PE) is multidetector computed tomography pulmonary angiography (CTPA) - a readily available and widely used imaging technique. Through technological advancements over the past years, alternative imaging techniques for the diagnosis of PE have become available, whilst others are still under investigation. In particular, the evolution of artificial intelligence (AI) is expected to enable further innovation in diagnostic management of PE. In this narrative review, current CTPA techniques and the emerging technology photon-counting CT (PCCT), as well as other modern imaging techniques of acute PE are discussed, including CTPA with iodine maps based on subtraction or dual-energy acquisition, single-photon emission CT (SPECT), magnetic resonance angiography (MRA), and magnetic resonance direct thrombus imaging (MRDTI). Furthermore, potential applications of AI are discussed.

摘要

对于疑似急性肺栓塞(PE)患者,用于显示肺血管内血栓栓子的首选影像学检查是多排螺旋 CT 肺动脉造影(CTPA)——一种易于获得且广泛应用的影像学技术。近年来,随着技术的进步,用于诊断 PE 的替代影像学技术已经出现,而其他技术仍在研究中。特别是人工智能(AI)的发展有望为 PE 的诊断管理带来进一步的创新。在这篇叙述性综述中,讨论了当前的 CTPA 技术和新兴的光子计数 CT(PCCT)技术,以及急性 PE 的其他现代影像学技术,包括基于减影或双能采集的碘图 CTPA、单光子发射 CT(SPECT)、磁共振血管造影(MRA)和磁共振直接血栓成像(MRDTI)。此外,还讨论了 AI 的潜在应用。

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