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目的分析双源CT双能量肺灌注成像(DEPI)技术评价急性肺动脉栓塞(APE)严重程度的可行性。方法经双源CT诊断APE24例,采用Lung PBV软件进行数据处理,得到CT肺血管图像(CTPA)和DEPI,分别计算每位患者的灌注缺损指数、栓塞指数及双室短轴最大径比(RV/LV),依据患者严重程度分为严重APE组(n=9)和非严重APE组(n=15),比较两组灌注缺损指数、栓塞指数及RV/LV,并进行Spearman等级相关分析。结果严重APE组的灌注缺损指数、栓塞指数及RV/LV中位数分别为32.5%(15.0%~62.5%)、45.0%(27.5%~75.0%)和1.16(1.04~1.45),而非严重APE组分别为12.5%(0%~37.5%)、12.5%(2.5%~42.5%)和1.03(0.85~1.41),严重APE组的各项指标均高于非严重组,两组间差异有统计学意义(P<0.05)。相关分析显示,灌注缺损指数与RV/LV及栓塞指数均呈正相关(分别为r=0.635,P<0.05;r=0.790,P<0.05)。结论采用双源CT双能量肺灌注成像技术评价APE严重程度具有一定可行性。
Objective To analyze the feasibility of dual-source CT dual-energy lung perfusion imaging (DEPI) in assessing the severity of acute pulmonary embolism (APE). Methods Twenty-four cases of APE were diagnosed by dual-source computed tomography (CT). Lung PBV software was used for data processing. CT pulmonary vascular images (CTPA) and DEPI were obtained. The perfusion defect index, / LV) were divided into severe APE group (n = 9) and non-serious APE group (n = 15) according to the patient’s severity. The perfusion defect index, embolism index and RV / LV were compared between two groups. Spearman rank correlation analysis was performed. Results The severity of APE was significantly lower in patients with APE compared with 32.5% (15.0% -62.5%), 45.0% (27.5% -75.0%) and 1.16 (1.04-1.45) in the APE group, APE group was 12.5% (range, 0% -37.5%), 12.5% (2.5% -42.5%) and 1.03 (0.85-1.41) respectively. The indexes of severe APE group were higher than those of non-serious group Statistical significance (P <0.05). Correlation analysis showed that perfusion defect index was positively correlated with RV / LV and embolism index (r = 0.635, P <0.05, respectively; r = 0.790, P <0.05). Conclusion It is feasible to assess the severity of APE by dual-source CT dual-energy lung perfusion imaging.