Dual Energy Perfusion Imaging Using Dual Source CT In The Diagnosis And Clinical Application Of Pulmonary Embolism

Objective: To investigate the clinical value of dual-source CT dual-energy pulmonary arteriography in the diagnosis and evaluation of pulmonary embolism(PE).Methods: A retrospective analysis of our hospital from January 2014 to December2017 admitted to the CTPA confirmed 50 cases of PE patients,and clinical anticoagulant or thrombolytic therapy,treatment 3 months after the application of dual-source CT(DSCT(CTPA)and dual-energy lung perfusion imaging(DEPI)were obtained respectively by using dual-energy software Lung-PBV(lung perfusion)Diagnostic criteria were compared before and after treatment of PE imaging changes,that is,the location of the PE before and after treatment,the number,type and scope of DEPI images perfusion defects or perfusion site,number,type and extent of reduction;application of consistency test(Kappa test)To analyze the consistency between the two and DEPI diagnosis of PE specificity and sensitivity.Results: A total of 1000 effective pulmonary segments were detected in 50 patients with PE,427 pulmonary embolisms were detected in CTPA before treatment,408 perfusion defects were detected or decreased in DEPI.The coincidence rate of DEPI and CTPA in diagnosing pulmonary embolism was 83.5% Kappa coefficient: 0.682,P <0.001,consistency is good.DEPI perfusion defect type and CTPA embolism type correlation analysis results: x2 value = 250.8,P <0.001.50 cases of PE patients after clinical anticoagulant or thrombolytic therapy for 3 months after the review,CTPA as the diagnostic criteria,the treatment Before and after comparison and partial and complete PE paired X2 test,x2 value: 5.68,P value of <0.001,the difference was statistically significant.DEPI as the diagnostic criteria,before and after treatment ofspot-like,patchy and sub-segment pulmonary embolism were paired X2 test,x2 value:6.38,P value of <0.001,the difference was statistically significant.Conclusion:DSCT not only provides information on the morphology of blood vessels in conventional CT pulmonary angiography,but also reflects the perfusion of lung tissue.CT pulmonary angiography(CTPA)combined with dual energy perfusion imaging(DEPI)Correct judgment of pulmonary embolism,and in the treatment of PE after treatment has important clinical value.