Diagnostic Value of Sixteen Slice SCT and Pulmonary Perfusion/ventilation Imaging in Pulmonary Embolism
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Objective To evaluate the value of the sixteen slice spiral CT and pulmonary perfusion/ventilation imaging in diagnosis of pulmonary embolism.Methods Imaging data (spiral CT scanning plus enhanced scanning and pulmonary perfusion/ventilation imaging) in 32 cases diagnosed as pulmonary embolism were retrospectively compared and analyzed.Results The detecting rate of spiral CT enhanced scanning was 90.6%.Pulmonary segments involved in 43.2%, while the detecting rate of the pulmonary perfusion and ventilation imaging was 84.4% and the involved rate of pulmonary embolism was 36.8% ,respectively.Conclusion Spiral CT enhanced scanning is a perfect method for observing direct sign of pulmonary embolism, especially combined with pulmonary perfusion/ventilation imaging.Keywords:
Ventilation perfusion mismatch
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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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To evaluate the potential value of precision dual-slice spiral computed tomographic pulmonary angiography (DSCTPA) in the diagnosis of pulmonary thrombo embolism (PTE), especially small PTE.Seventy-four patients sus Pected of having PTE received DSCTPA. The diagnosis was confirmed in all cases by D-dimer, blood P((A-a))O(2) and cardiac sonography, by direct pulmonary angiography (DPA)in 12, by ventilation-Pe rfusion scan (V-PS) in 6, and 28 underwent lower extremity sonography.DSCTPA revealed central pulmonary thromboembolism (CPTE) in 24 cases and Peripheral pulmonary embolism (PPTE) in 34 cases; true negative in 10 cases, false positive in 3 cases and false negative in 3 cases. Direct signs included partial filling defect (60%), complete occlusion (31%), railway-track sign (3%), mural filling defect (2%), low perfusion and varied lung density (4%). Indirect signs included pulmonary artery dilatation in 16 cases (28%), focal fine pulmonary blood vessels 28 (48%), mosaic sign 4 (7%), effusion 9 (16%), atelectasis 9 (16%), cuniform change 5 (9%), ground glass shadow 7 (12%) and lymphnode enlargement 5 (9%). DSCTPA was more sensitive than V/QS scanning (P < 0.001) and DPA (P < 0.001) in the PPTE group. The sensitivity was 92%, specificity 77%, accuracy 88%, positive predictive value 92%, and negative predictive value 77%.DSCTPA is a noninvasive, effective and reliable method for diagnosing PTE, especially small PTE, for which it could increase the detection rate.
Pulmonary angiography
Spiral computed tomography
Atelectasis
Pulmonary Infarction
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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 study the role of pulmonary angiography with multi-slice spiral CT in the diagnosis of pulmonary embolism (PE). Methods Nineteen patients suspected of pulmonary embolism were examined with CT pulmonary angiography,and the technique of maximum intensity projection (MIP),volume rendering technique (VRT) and multiplanar reformation (MPR). Results PE was diagnosed in 12 of 19 patients,and 104 branches were detected,including main pulmonary arteries,lobar arteries,segment arteries,and deuto-segment arteries. Conclusion Multi-slice spiral CT pulmonary angiography is non-invasive,fast and highly sensitive for diagnosis of PE.
Maximum intensity projection
Pulmonary vasculature
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 evaluate the value of 16-slice spiral CT pulmonary angiography in detecting peripheral pulmonary embolismin canine models. Methods The peripheral pulmonary embolism animal modes were made in 9 dogs by introducing gelatin sponge of2～4 mm in diameter and 1 cm at length into pulmonary arteries through a catheter under DSA,MSCTPA examination was performed 10 dayslatter, the original images were reconstructed at the console workstation. The image findings were compared with that of pathologicaldissections.Results The program of pulmonary embolism models in 9 cases was finished and pulmonary infarction were found in four dogs,52 pulmonary arteries including 2 lode arteries , 18 segmental arteries and 32 subsegmental arteries were involved to be found on MSCTPA,while 55 pulmonary arteries including 2 lode arteries,18 segmental arteries and 35 subsegmental arteries were involved in pathologicaldissections .The accuracy of 16-slice spiral CT pulmonary angiography in diagnosis of peripheral pulmonary embolism and subsegmental pulmonary embolism was 94.34% and 91.43%,respectively, the positive predictive value was 94.12% in latter.Conclusion 16-slice spiral CT is a feasible method in diagnosing pulmonary embolism.
Spiral computed tomography
Pulmonary Infarction
Pulmonary angiography
Coronary arteries
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Objective:To discuss the diagnostic value of spiral CT pulmonary angiography in the diagnosis of pulmonary embolism(PE).Methods:12 patients with PE were performed spiral CT volume scanning.Three dimensional and multiplanar images of pulmonary artery were obtained after post procession in the work station.Results:Among 196 branches of pulmonary arteries in 12 patients,PE was found in 46.4%.Embolism located in main pulmonary artery,left or right pulmonary artery,lobar arteries and segmental arteries.On multiplanar images,it showed intraluminal filling defect or no contrast medium in distant pulmonary arteries.On the pulmonary angiography images,it showed filling defect or cutting off sign in main pulmonary arteries;similar changes were observed in the lobar or segmental branches.Conclusion:SCTA images could obtain more diagnostic imformation by observing PE from different directions.SCTA is a reliable method in diagnosis of PE above the level of lobar or segmental artery.
Pulmonary angiography
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Neuroradiology
Multislice
Bronchial artery
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Objective To evaluate the application of 64 slice spiral computer tomography pulmonary angi- ography in the diagnosis of pulmonary embolism (PE) for pulmonary embolism from technical aspects.Methods 62 suspected pulmonary embolism (PE) patients were performed 64 slice spiral CT pulmonary artery angiography ,the results of CTPA were analyzed.Maximum intensity projection (MIP),multiplanar reformation (MPR),curved planar reformation (CPR),volume rendering (VR) and virtual endoscopy(VE) were applied.Results CTA could distinctly display 152 pulmonary emboli of 24 patients including the location,shape,and scope of PE. Conclusion 64 slice spiral CT pulmonary angiography is a fast and accurate and non-invasive diagnostic method for PE,it may be the chief diagnostic method,having obvious technique advantage in the diagnosis of PE.
Maximum intensity projection
Pulmonary angiography
Spiral computed tomography
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