Volumetric evaluation of dual-energy perfusion CT by the presence of intrapulmonary clots using a 64-slice dual-source CT.
Acta Radiol
; 54(6): 628-33, 2013 Jul.
Article
in En
| MEDLINE
| ID: mdl-23474766
ABSTRACT
BACKGROUND:
Dual-energy perfusion CT (DEpCT) directly represents the iodine distribution in lung parenchyma and low perfusion areas caused by intrapulmonary clots (IPCs) are visualized as low attenuation areas.PURPOSE:
To evaluate if volumetric evaluation of DEpCT can be used as a predictor of right heart strain by the presence of IPCs. MATERIAL ANDMETHODS:
One hundred and ninety-six patients suspected of having acute pulmonary embolism (PE) underwent DEpCT using a 64-slice dual-source CT. DEpCT images were three-dimensionally reconstructed with four threshold ranges 1-120 HU (V120), 1-15 HU (V15), 1-10 HU (V10), and 1-5 HU (V5). Each relative ratio per V120 was expressed as the %V15, %V10, and %V5. Volumetric data-sets were compared with D-dimer, pulmonary arterial (PA) pressure, right ventricular (RV) diameter, RV/left ventricular (RV/LV) diameter ratio, PA diameter, and PA/aorta (PA/Ao) diameter ratio. The areas under the ROC curves (AUCs) were examined for their relationship to the presence of IPCs. This study was approved by the local ethics committee.RESULTS:
PA pressure and D-dimer were significantly higher in the patients who had IPCs. In the patients with IPCs, V15, V10, V5, %V15, %V10, and %V5 were also significantly higher than those without IPC (P ≤ 0.001). %V5 had a better correlation with D-dimer (r = 0.30, P < 0.001) and RV/LV diameter ratio (r = 0.27, P < 0.001), and showed a higher AUC (0.73) than the other CT measurements.CONCLUSION:
The volumetric evaluation by DEpCT had a correlation with D-dimer and RV/LV diameter ratio, and the relative ratio of volumetric CT measurements with a lower attenuation threshold might be recommended for the analysis of acute PE.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pulmonary Embolism
/
Tomography, X-Ray Computed
Type of study:
Prognostic_studies
Aspects:
Ethics
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Acta Radiol
Year:
2013
Document type:
Article