中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2020, Vol. 42 ›› Issue (5): 646-650.doi: 10.3881/j.issn.1000-503X.11741

• 论著 • 上一篇    下一篇

双源CT双能量肺灌注成像对肺动脉栓塞的诊断价值

沈维英,刘虎(),朱佩云,陈园,乔洪梅,苏刚,赵宏伟,蒋伟浩   

  1. 浙江省嘉兴市第二医院放射科,浙江嘉兴 314000
  • 收稿日期:2019-07-10 出版日期:2020-10-30 发布日期:2020-11-02
  • 通讯作者: 刘虎 E-mail:15157400891@163.com
  • 基金资助:
    嘉兴市科技计划项目基金(2020AD30118)

Diagnostic Value of the Dual Source CT Dual Energy Pulmonary Perfusion Imaging for Pulmonary Embolism

SHEN Weiying,LIU Hu(),ZHU Peiyun,CHEN Yuan,QIAO Hongmei,SU Gang,ZHAO Hongwei,JIANG Weihao   

  1. Department of Radiology,the Second Hospital of Jiaxing,Jiaxing,Zhejiang 314000,China
  • Received:2019-07-10 Online:2020-10-30 Published:2020-11-02
  • Contact: LIU Hu E-mail:15157400891@163.com
  • Supported by:
    Jiaxing Science and Technology Program(2020AD30118)

摘要:

目的 评估双源CT双能量肺灌注成像(DEPI)对肺动脉栓塞的诊断价值。方法 回顾性分析2017年8月至2018年7月在嘉兴市第二医院收治的临床诊断疑似肺动脉栓塞成功行DEPI检查的87例患者的临床资料,以CT肺动脉造影(CTPA)诊断结果为参照标准,分别以患者和肺叶为评价单位,采用诊断性试验计算DEPI对肺动脉栓塞检出的诊断符合率、灵敏度、特异度、阳性预测值、阴性预测值、Youden指数、阳性似然比、阴性似然比,并计算Kappa系数值,评价DEPI与CTPA诊断结果的一致性。结果 分别以患者和肺叶为评价单位,DEPI对肺动脉栓塞检出的诊断符合率分别为85.06%和89.57%,灵敏度为88.41%和76.80%,特异度为72.22%和96.82%,阳性预测值为92.42%和93.20%,阴性预测值为61.90%和88.02%,Youden指数为0.61和0.74,阳性似然比为3.18和24.15,阴性似然比为0.16和0.24,DEPI与CTPA诊断结果分别具有较好和极好的一致性(Kappa值为0.571和0.765)。结论 DEPI对于肺动脉栓塞的检出具有较高的准确率、敏感度和特异度,将DEPI联合CTPA应用可同时得到解剖结构和功能信息影像,大大提高肺动脉栓塞的诊断准确率,应作为临床疑似肺动脉栓塞患者的首选检查方法。

关键词: 双能量肺灌注成像, 肺动脉造影, 肺动脉栓塞, 双源CT

Abstract:

Objective To assess the diagnostic value of dual energy pulmonary perfusion imaging(DEPI)for pulmonary embolism.Methods The clinical data of 87 patients with suspected pulmonary embolism who had received DEPI between August 2017 and July 2018 in Jiaxing Second Hospital were retrospectively analyzed.With the findings of CT pulmonary angiography(CTPA)as the reference standard and with patients and pulmonary lobes as evaluation units,respectively,a diagnostic test was performed to calculate the diagnostic coincidence rate,sensitivity,specificity,positive predictive value,negative predictive value,Youden index,positive likelihood ratio,negative likelihood ratio,and Kappa coefficient value for the diagnosis of DEPI and CTPA.Results The coincidence rate,sensitivity,specificity,positive predictive value,negative predictive value,Youden index,positive likelihood ratio,and negative likelihood ratio were 85.06%,88.41%,72.22%,92.42%,61.90%,0.61,3.18,and 0.16,respectively,when applying the patients as evaluation units.When the pulmonary lobes were invoked as evaluation units,the above-mentioned indexes were 89.57%,76.80%,96.82%,93.20%,88.02%,0.74,24.15,and 0.24,respectively.The diagnostic results of DEPI and CTPA had a good and excellent consistency,respectively(Kappa value=0.571,0.765).Conclusions DEPI has high accuracy,sensitivity,and specificity in the detection of pulmonary embolism.The combination of DEPI with CTPA can simultaneously obtain the anatomical structure and functional information images,greatly improving the diagnostic accuracy for pulmonary embolism.Thus,it can be used as the preferred examination for patients with clinically suspected pulmonary embolism.

Key words: dual energy pulmonary perfusion imaging, pulmonary angiography, pulmonary embolism, dual source CT

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