Value Of Post-MSCT Processing Technology And Protein Degradation Products To Diagnosis Of Pulmonary Embolism

Objective(Research purposes):Retrospective study was conducted to analyze the value for PE diagnosis by using MSCTA post-processing technologies in combination with D-dimer and FDPs,the degradation product of plasma fibrin(fibrinogen).Methods:In this study with retrospective analysis,104 patients with pulmonary embolism diagnosed and treated in Taian traditional Chinese Medicine Hospital,were selected as the research objects to test D-dimer and FDPs in their blood and have MSCTA examination.After that,image post-processing technology was used to process the images.In the control group,80 healthy volunteers were selected to test D-dimer and FDPs in their blood.Mann-Whitney U was used to test,analyze and draw ROC curve of plasma D-dimer,FDPs and CTA post-processing technology.The maximum tangent point of Youden index was chosen as the optimal critical value to calculate the sensitivity,specificity and accuracy.Results:The age of the 104 research objects,including 69 males and 35 females,ranged from 32 to 75,with an average value of(51.8±6.12).The age of 20 volunteers in the control group,including 15 males and 5 females,ranged from 28 to 69,with an average value of(50.3±4.26).After analysis with normality test and Mann-Whitney U test,the D-dimer level in the patient group was 4.75±2.28mg/ml,and that in the control group was 1.45±0.38mg/ml.The difference between them is statistically significant(P<0.05).The FDPs level in the patient group was 7.64±3.81 ug/L,and that in the control group was 1.53± 1.02 ug/L.The difference between them is statistically significant(P<0.05).In the patient(PE)group,95 cases of pulmonary artery filling-defect embolus were found by MSCTA combined examination.Among different post-processing technologies for positive detection rate,MPR technology is more superior in showing tiny embolism,with higher detection rate.Using VR,MIP and MPR technologies to reconstruct the images can clearly show the spatial structure and anatomical relationship.MIP image can reflect the density difference of tissues more authentically and show the shape,course,abnormal changes and distribution range of blood vessels strengthened by contrast medium clearly and accurately.VR image can show the anatomical relationship between lesions and blood vessels,as well as between blood vessels and other surrounding organs multi-dimensionally,intuitively and stereoscopically,so as to further show the filling-defect lesion images as well as the vascular deformations and abnormal lesions clearly and stereoscopically.The combined application of the three post-processing technologies can significantly improve the accuracy of diagnosis of tiny pulmonary artery embolism.The DD positive rate and the detection rate and accuracy of MSCTA for patients with pulmonary embolism were up to 90.38%and 91.35%,respectively.The positive rate of abnormal increase of FDPs was low,only 60.58%.The analysis by combining the three methods can significantly improve the detection rate.A total of 99 cases were confirmed as pulmonary embolism,with a diagnosis rate of 95.19%.For FDPs,the area under the ROC curve for diagnosing PE was 0.505,with the 95%CI of 0.331-0.677,and the corresponding sensitivity and specificity were 77.78%and 50%,respectively.For DD,the area under the ROC curve was 0.776,with the 95%CI of 0.603-0.899,and the corresponding sensitivity and specificity were 85.71%and 71.43%,respectively.For MSCTA,the area under the ROC curve was 0.923,with the 95%CI of 0.782-0.986,and the corresponding sensitivity and specificity were 92.86%and 85.71%,respectively.For the detection by combining the three methods,the area under the ROC curve was 0.898,with the 95%CI of 0.748-0.974,and the corresponding sensitivity and specificity were 96.30%and 87.50%,respectively.The analysis results indicate that the specificity and positive predictive value of MSCTA in the diagnosis of PE were higher than those of plasma D-dimer and FDPs.When the scores of the three methods were combined,both sensitivity and specificity were enhanced.Conclusion:The MSCTA post-processing technologies,in combination with monitoring the changes of D-dimer and FDPs levels,can significantly enhance the sensitivity and specificity of pulmonary embolism diagnosis,which is of a high guiding value and significance in the early diagnosis and treatment of pulmonary embolism.