Quantitative lung perfused blood volume imaging on dual-energy CT: capability for quantitative assessment of disease severity in patients with acute pulmonary thromboembolism.

BACKGROUND:Regional iodine distribution assessment on dual-energy computed tomography (DECT) has been suggested as useful for management of acute pulmonary thromboembolism (APTE) patients. However, no reported studies have made a direct comparison between quantitatively assessed DECT and right-to-left ventricular (RV/LV) ratio on CT for differentiation of right heart dysfunction (RHD) from non-right heart dysfunction (NRHD) in APTE patients.PURPOSE:To determine the capability of DECT for differentiation of RHD from NRHD in APTE patients.MATERIAL AND METHODS:Thirteen APTE patients underwent DECT and echocardiography at onset of APTE. Patients were divided into RHD (n = 7) and NRHD (n = 6) groups based on echocardiography. A normalized lung perfused blood volume map was generated, and two kinds of overall perfusion (OP) index were determined, one placed over each lung field (OP index A) and as the average from six regions of interest (ROIs) placed over each lung field (OP index B). The heterogeneity index was also determined as the standard deviation for the six ROIs. RV/LV ratio evaluations were also performed. To assess differences between the two groups, each index was statistically compared with the Mann-Whitney U test. The receiver-operating curve-based positive test was then performed to determine the feasible threshold value for dividing patients into the two groups. Finally, differentiation capabilities of the indexes were compared using McNemar's test.RESULTS:Significant differences between the two groups were found for both OP indexes and RV/LV ratio (P < 0.05). For each of the feasible threshold values, accuracy of each OP index with and without RV/LV ratio was better than that of the RV/LV ratio.CONCLUSION:Quantitative DECT has good potential for differentiation of APTE patients with and without right heart dysfunction.;博士(医学)・乙第1350号・平成26年12月3日;© The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.;開始ページ : 0284185114524953;終了ページ : 0284185114524953;PubMed番号 : http://www.ncbi.nlm.nih.gov/pubmed/24567523

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書名 Quantitative lung perfused blood volume imaging on dual-energy CT: capability for quantitative assessment of disease severity in patients with acute pulmonary thromboembolism.
著作者等 Kichikawa, Kimihiko
Kimura, Hiroshi
Ohno, Yoshiharu
Miura, Sachiko
書名別名 Dual-Energy CTを用いた肺血液量画像の定量的評価:急性肺血栓塞栓症患者に対する定量的重症度評価
出版元 Sage / Foundation Acta Radiologica
刊行年月 1987-
ページ数 v.
大きさ 28 cm
ISSN 02841851
NCID AA10668717
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言語 英語
出版国 スウェーデン
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