Comparison Of CTPA And Pulmonary Q-SPECT/CT In The Diagnosis Of Pulmonary Embolism

Objective: To compare the value of diagnosis of pulmonary embolism between CTPA and lung Q-SPECT/CT.Method: Pulmonary embolism patients who underwent pulmonary Q-SPECT/CT imaging and CTPA examination were retrospectively analyzed from the First Affiliated Hospital of Dalian Medical University from June 2016 to October 2017.Group A(1 nuclear medicine professional physician and a radiologist)and grou p B(1 nuclear medicine professional physician and 1 radiology professional physician)respectively judge the presence of thrombus and its location in double-bli nd manner,and scoring for lung Q-SPECT/CT and CTPA in evaluating pulmonar-y artery thrombosis load by Mastora embolization index and lung segment appar ent index.To compare the sensitivity,specificity,accuracy,positive predictive val-ue,negative predictive value of the two methods and plot the respective ROC c-urves to compare the area under the curve in diagnosing pulmonary embolism,a-nalyze the correlation of pulmonary artery thrombosis load score of the two met-hods and compare the two methds in the diagnosis of lung segment and subseg ment thrombus is to assess the diagnostic value of pulmonary Q-SPECT/CT imag-ing and CTPA in the diagnosis of pulmonary embolism.Result: A total of 30 samples are cellected.In group A,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CTPA in diagnosis of pulmonary embolism were 70%,85%,80%,77.8% and 85% res-pectively;the sensitivity,specificity,accuracy,positive predictive value and negat-ive predictive value of lung Q-SPECT/CT in diagnosis of pulmonary embolism of were 90%,80%,83.3%,69.2% and 94.1% respectively;the area under the ROC curve(AUC)of CTPA in diagnosis of pulmonary embolism was 0.808,the ar-ea under the ROC curve(AUC)of lung Q-SPECT/CT in diagnosis of pulmonar-y embolism was 0.850,and the P value <0.05.In group B,the sensitivity,spe-cificity,accuracy,positive predictive value and negative predictive value of CTPA in diagnosis of pulmonary embolism were 70%,85%,80%,77.8% and 89.5%respectively;the sensitivity,specificity,accuracy,positive predictive value and neg-ative predictive value of lung Q-SPECT/CT in diagnosis of pulmonary embolism were 90%,85%,80%,69.2% and 93.8% respectively;the area under the ROC curve(AUC)of CTPA in diagnosis of pulmonary embolismwas 0.763,the area under the ROC curve(AUC)of lung Q-SPECT/CT in diagnosis of pulmonary emb-olism was 0.853,and the P value <0.05.There was no correlation between lun-g Q-SPECT/CT and CTPA in evaluating pulmonary artery thrombosis by Mastor a embolization index and lung segment apparent index.The quantity of cumulative detected lung segment thrombosis by CTPA is more than lung Q-SPECT/CT and the difference between the results of two methods is statistically significant(P<0.05);the quantity of cumulative detected lung subsegment thrombosis by lung Q-SPECT/CT is more than CTPA and the difference between the results of two methods is statistically significant(P<0.05).The kappa value between the two groups of CTPA readers and lung Q-SPECT/CT readers is 0.794 and 0.993~1.The Cronbach’s Alpha value between the two groups in Mastora embolus index scores evaluated by CTPA readers was 0.996;the Cronbach’s alpha value of bet-ween the two groups in lung segment apparent index scores evaluated by lung Q-SPECT/CT readers was 0.992.Conclusion: 1.In the aspect of overall diagnostic efficacy,the AUC of lung QSPECT/CT is larger to the AUC of CTPA.2.There was no correlation between lung Q-SPECT/CT and CTPA in evaluating pulmonary artery thrombosis by Mastora embolization index and lungsegment apparent index.3.In the diagnosis of pulmonary subsegmental artery thrombosis,lung Q-SPECT/CT is superior to CTPA;in the diagnosis of pulmonary segmental artery thrombos,CTPA is superior to lung Q-SPECT/CT.