Suyon Chang1, Jin Hur2, Dong Jin Im1, Young Joo Suh1, Yoo Jin Hong1, Hye-Jeong Lee1, Young Jin Kim1, Byoung Wook Choi1. 1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea. 2. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea. khuhz@yuhs.ac.
Abstract
OBJECTIVES: The purpose of this study was to determine whether dual-energy computed tomography (DECT) angiography could differentiate pulmonary thromboembolism (PTE) from pulmonary artery sarcoma (PAS). METHODS: We prospectively enrolled 19 patients that had a filling defect in the main pulmonary artery on DECT. Six patients who had PAS and underwent DECT were retrospectively enrolled for comparison. Pathological results or follow-up CT after anticoagulation therapy were used to make the final diagnosis. Two investigators measured the following parameters at the filling defect in the main pulmonary artery: CT attenuation density [Hounsfield units (HU)], iodine-related HU (IHU) and iodine concentration (IC, mg/ml). RESULTS: From a total of 25 patients (M:F = 10:15; mean age, 65 years old), 19 were categorised into the PTE group and six were categorised into the PAS group. The mean HU values were not significantly different between the PTE and PAS groups (45.5 ± 15.9 vs 47.1 ± 9.2 HU; P = 0.776). However, the mean IHU and IC values of the lesions were significantly different between the PTE and PAS groups (10.6 ± 7.2 vs 27.9 ± 9.1 HU; P = 0.004, and 0.61 ± 0.39 vs 1.49 ± 0.57; P = 0.001). CONCLUSIONS: DECT angiography using a quantitative analytic methodology can be used to differentiate PTE and PAS. KEY POINTS: • DECT can be useful for differentiation of PAS and PTE. • With quantitative analysis, DECT offers tissue characterisation by detecting lesion parameter increases. • The patients without predisposing factors for PTE can be candidates for DECT.
OBJECTIVES: The purpose of this study was to determine whether dual-energy computed tomography (DECT) angiography could differentiate pulmonary thromboembolism (PTE) from pulmonary artery sarcoma (PAS). METHODS: We prospectively enrolled 19 patients that had a filling defect in the main pulmonary artery on DECT. Six patients who had PAS and underwent DECT were retrospectively enrolled for comparison. Pathological results or follow-up CT after anticoagulation therapy were used to make the final diagnosis. Two investigators measured the following parameters at the filling defect in the main pulmonary artery: CT attenuation density [Hounsfield units (HU)], iodine-related HU (IHU) and iodine concentration (IC, mg/ml). RESULTS: From a total of 25 patients (M:F = 10:15; mean age, 65 years old), 19 were categorised into the PTE group and six were categorised into the PAS group. The mean HU values were not significantly different between the PTE and PAS groups (45.5 ± 15.9 vs 47.1 ± 9.2 HU; P = 0.776). However, the mean IHU and IC values of the lesions were significantly different between the PTE and PAS groups (10.6 ± 7.2 vs 27.9 ± 9.1 HU; P = 0.004, and 0.61 ± 0.39 vs 1.49 ± 0.57; P = 0.001). CONCLUSIONS: DECT angiography using a quantitative analytic methodology can be used to differentiate PTE and PAS. KEY POINTS: • DECT can be useful for differentiation of PAS and PTE. • With quantitative analysis, DECT offers tissue characterisation by detecting lesion parameter increases. • The patients without predisposing factors for PTE can be candidates for DECT.
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