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- Title
Volumetric evaluation of dual-energy perfusion CT by the presence of intrapulmonary clots using a 64-slice dual-source CT.
- Authors
Okada, Munemasa; Nakashima, Yoshiteru; Kunihiro, Yoshie; Nakao, Sei; Morikage, Noriyasu; Sano, Yuichi; Suga, Kazuyoshi; Matsunaga, Naofumi
- Abstract
<bold>Background: </bold>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. <bold>Purpose: </bold>To evaluate if volumetric evaluation of DEpCT can be used as a predictor of right heart strain by the presence of IPCs. <bold>Material and Methods: </bold>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. <bold>Results: </bold>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. <bold>Conclusion: </bold>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.
- Subjects
PERFUSION; TOMOGRAPHY; BRAIN; RADIOGRAPHY; PULMONARY embolism; BLOOD coagulation
- Publication
Acta Radiologica, 2013, Vol 54, Issue 6, p628
- ISSN
0284-1851
- Publication type
journal article
- DOI
10.1177/0284185113479053