On value of the dual source CT dual energy perfusion imaging for the diagnosis of pulmonary embolism
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Objective To study the diagnostic value of dual source CT dual energy perfusion imaging( DEPI) for pulmonary embolism. Methods A retrospective analysis of clinical data was conducted in 95 patients with a clinical diagnosis of pulmonary embolism suspected who were admitted in Nanshan hospital from March 2010 to February 2014. All of them underwent dual energy imaging. The images were evaluated with lung PBV software on the workstation,then CT pulmonary angiography( CTPA),DEPI and fusion image were obtained. The number and location of PE in DEP I and CTPA were recorded and analyzed. The sensitivity,specificity,positive predictive value( PPV) and negative predictive value( NPV) of DEPI images for the diagnosis of PE were calculated. Results To lung as evaluation unit,the DEPI detection perfusion defect or sparse 47,CTPA checked out the corresponding vascular embodiment 50,the coincidence rate is94. 0%,Pulmonary segments as evaluation unit,the DEPI detected 145 lung segment have perfusion defects or reduction,and the CTPA detected 156 embolus coincidence rate was 93. 0%. Pulmonary subsegment as evaluation unit,DEPI detected 81 lung subsegment have perfusion defects or reduction,and the CTPA detected 103 embolus coincidence rate was 79. 0%. The sensitivity,specificity,PPV and NPV of DEPI for the diagnosis of PE was 94. 0%,83. 0%,94. 0%,89. 0%,the K value was 0. 82. Conclusion the dual source CT dual energy perfusion imaging can sensitively display pulmonary embolism caused by perfusion defects or sparse,make up for the CTPA show distal pulmonary embolus deficiency,and can also provide functional and anatomical information,improve the accuracy of diagnosis of pulmonary embolism.Keywords:
Pulmonary angiography
Embolus
Dual energy
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Objective To evaluate the feasibility and clinical value of 320 detector row CT single volume scan pulmonary angiography in the diagnosis of pulmonary embolism(PE).Methods Seventy -five patients(60 years) suspected to have PE underwent 320 detector row CT single volume scan pulmonary angiography.The post processing techniques included VR.MPR and CPR. The data were analyzed and the feasibility and clinical value of this new scan model were assessed. Results All of 75 cases completed the exam successfully,and the quality of the image was good enough for diagnosis,41 cases were dianosed as PE,including 12 with segmental PE.In other 34 cases,PE was ruled out.The diagnoses were verified by ventilation/perfusion scintigraphy and effective anticoagulant-thrombolysis therapy.For every patient,the scan time of 320 detector row CT single volume scan pulmonary angiography was 1 s,the amount of contrast agent used was 45 ml,and the average radiation exposure was(2.73 ± 0.47) mSv.Conclusion 320 detector row CT single volume scan pulmonary angiography is a noninvasive imaging method which is feasible to evaluate the morphology of pulmonary artery and to diagnose pulmonary embolism accurately.Because of the advantages such as low radiation exposure and low dose of contrast agent and rapid imaging,this scan mode is particularly applicable to acute severe patients and old patients.
Pulmonary angiography
Flat panel detector
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Objective:To investigate the methods and technique of multislice spiral CT in diagnosis of acute pulmonary embolism (PE) and deep vein thrombosis (DVE).Methods:21 patients with clinically suspected PE were enrolled in this study.After the thorax plain CT scanning,multislice spiral CT pulmonary angiography (CTPA) was performed with a delay of 20 second from the beginning of intravenous administration of contrast material 100ml at a rate of 3ml/s.Indirect CT venography (CTV) was performed after a delay of 150s with a non-spiral scanning protocol of 1mm collimation and 30mm gaps from diaphragm to upper portion of gastrocnmius muscle.multi planar reconstruction (MPR) and surface shaded display (SSD)、maximum Intensity projection (MIP) were carried out.Results:MSCTPA demonstrated PE in 12 patients,and the CTV revealed 8 cases of DVT (There were 7 cases of DVT complicated with PE) in the 12 patients.With a delay of 20s for CTPA and 150s for CTV,the pulmonary artery and deep vein were well demonstrated.The embolism manifested as partial or complete intravascular filling defect.MPR was superior to SSD and MIP in depicting the embolism.Conclusion:CTPA is a safe,non-invasive and cost-effective diagnostic method for the diagnosis of PE and DVT.
Pulmonary angiography
Multislice
Maximum intensity projection
Spiral computed tomography
Diaphragm (acoustics)
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Pulmonary angiography
Dual energy
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Objective To discuss 64-slice spiral CT pulmonary angiography(CTPA) with a variety of image processing methods in the diagnosis of pulmonary embolism(PE).Methods The clinical data of 64 cases with suspected PE were selected since January 2009,from which a retrospective diagnosis was made with different image processing methods.Results When examining arteries in 1 level,there was no significant difference between MPR,MIP and VR in detection rate.For arteries in 2-3 level,MPR had a higher detection rate,which was significantly different from MIP and VR(P 0.05).For arteries in 4-5 level,MPR also had a higher detection rate than MIP and VR,but the results showed no statistical significance(P 0.05).Conclusions Combined with a variety of image processing methods,CTPA can increase the detection rate of PE,which is conducive to the early diagnosis,clinical evaluation and reduction of mortality,providing a basis for surgical treatment.
Clinical Significance
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Objective:To study the valuation of multi-slice spiral CT in the diagnosis of pulmonary embolism.Methods:24 cases of pulmonary embolism were examined with multi-slice spiral CT pulmonary angiography,the reformation images consisted of 1.0 mm slices,with 0.7 mm reconstruction intervals and 0.75 mm slices,with 0.5 mm reconstruction intervals,VRT,MIP and MPR were adopted as post-processing techniques of CT pulmonary angiography,and then images were compared.Results:In 24 cases of PE,76 branches of pulmonary embolism were identified,including 6 aortopulmonay arteries,36 lobar arteries,27 segmental pulmonary arteries and 7 subsegmental pulmonary arteries,PE showed that was no a significant difference between images of 1.0 mm slices and 0.75 mm slices reformation.Conclusion:Multi-slice spiral CT pulmonary angiography proves to be highly sensitivity and strongly specificity for the diagnosis of pulmonary embolism,CTPA is safety,immediate,noninvasive,it shoud be the first choice for the detection of PE.
Pulmonary angiography
Spiral computed tomography
Pulmonary vasculature
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Objective: To investigate the value of diagnosis of pulmonary embolism by co-registration SPECT/CT image fusion.Methods:78 patients who were suspected pulmonary embolism were studied,man 26,female 52,28 to 80 years old.78 patients underwent 99mTc-MAA Lung perfusion image including eight-direction static imaging and SPECT/CT image fusion without changing the position of the patients.The emission image with X-ray map was reconstruct by OSEM.Results: Among 78 patients,40 were diagnosed pulmonary embolism by SPECT/CT.The sensitivity and specificity were 90%(36/40) and 84.2%(32/38),fake masculine and fake negative were 15.8%(6/38) and 10%(4/40).The exact rate of SPECT/CT image fusion was 87.2%(68/78)and was similar to that of pulmonary perfusion/ventilation imaging in literature reports.Conclusion: Pulmonary perfusion SPECT/CT image fusion can get both information of pulmonary perfusion and transparency in one study.The method had distinct advantages in diagnosing pulmonary embolism.
Spect imaging
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Objective To assess the clinical value of dual source CT dual energy lung perfusion imaging in the diagnosis of suspected pulmonary embolism(PE). Methods 25 patients with suspected PE received contrast enhanced dual source CT scanning with dual energy mode. The dedicated software of Dual Energy was used for image post-processing. The number and location of PE in dual energy perfusion imaging(DEPI) and CT pulmonary angiography(CTPA) were recorded respectively. Sensitivity and specificity were measured comparing to CTPA as a standard of reference. The relationship between range of lung perfusion abnormality in DEPI and cardiovascular measurements was analyzed. Result 21 lobes, 47 segmental and 37 sub-segmental were involved with pulmonary embolism. The 95.2%, 89.4% and 89.2% agreement between DEPI and CTPA were showed in the levels of lung and partial lung respectively. Complete filling defects of segmental and subsegmental pulmonary arteries mostly showed correspondence perfusion defects in the CT perfusion map. However, when there were partial filling defects, most of them were partial perfusion defects. A few of them were normal in the CT perfusion map. Otherwise, segmental perfusion defects were depicted without the visualization of endo-luminal thrombi in some patients. Conclusions DEPI may reveal abnormal perfusion resulted by PE. The combination of CTPA and DEPI will offer more information for diagnosis of the acute pulmonary embolism.
Dual energy
Pulmonary angiography
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To explore the relationship of the perfusion defects in the dual-energy CT lung perfusion image and the filling defects in the CT pulmonary angiography (CTPA) in patients with acute pulmonary embolism.The clinical data of 22 patients with acute pulmonary embolism were retrospectively analyzed. All of them underwent contrast CT scan in two phases using dual-energy CT: the first is pulmonary artery phase, and the second was performed immediately after the first phase using dual-energy scan covered the whole lung. Perfusion defects in the lung perfusion images were compared with the filling defects in the CTPA.Complete filling defects of segmental and subsegmental pulmonary arteries mostly showed correspondence perfusion defects in the CT perfusion map, accounting for 83% and 62% respectively. However, when there were partial or central filling defects, most of them were partial perfusion defects or normal in the CT perfusion map. Three segmental perfusion defects were depicted without the visualization of endoluminal thrombi within the corresponding arteries.The perfusion defects in the CT lung perfusion image are not completely corresponding to the filling defects in the CTPA. The combination of CTPA and CT lung perfusion map will offer more information for the acute pulmonary embolism.
Pulmonary angiography
Dual energy
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Objective To investigate the role of multi-detector spiral CT in diagnosis of acute pulmonary embolism (PE). Methods Thin collimation multi-detector spiral CT pulmonary angiography (CTPA) and CT venography (CTV) were preformed in 21 patients suspected of acute PE. Results CTPA detected 12 cases of acute PE while CTV detected 8 cases of deep vein thrombosis (DVT) in the 21 patients. 92.7% and 72.9% of segmental and subsegmental pulmonary arteries were visualized respectively in 1 mm effective thickness images while 87.9% and 39.3% of them were identified respectively by using 3 mm effective thickness images ( P 0.05). Seventy-five embolus in segmental and thirty-seven embolus in subsegmental pulmonary arteries were detected by analyzing 1 mm effective thickness images, while 53 in segmental and 15 in subsegmental pulmonary arteries were demonstrated by using 3 mm effective thickness images( P 0.05). Conclusion multi-detector spiral CT can facilitate the diagnosis of acute PE.
PULMONARY EMBOLUS
Embolus
Pulmonary angiography
Spiral computed tomography
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Objective To investigate the imaging methods and technique with 64-MSCT for detecting acute pulmonary embolism(PE). Methods 15 patients with clinically suspected PE were enrolled in this study. After the thorax plain CT scan and intravenous administration of contrast,each paitient underwent high-speed,thin-layer 64-MSCT scan for CT pulmonary angiograpny(CTPA). We also performed multiplanar reconstruction and 3-dimension rendition to provide lifelike view of the main pulmonary artery and its branches. We pick out the suitable parameter and optimize the scan process,also evaluate the value of CTPA for detecting PE,in order to observe the location and configuration of thrombi accurately. Results 7 patients with PE were revealed,the presence of PE was seen as filling defect in. Conclusion CTPA by 64-MSCT is a new modality for detecting PE,and it is noninvasive,safe,practical and effective.
Thorax (insect anatomy)
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