Munemasa Okada1, Takafumi Nomura1, Yoshiteru Nakashima2, Yoshie Kunihiro1, Shoji Kido3. 1. Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan. 2. Department of Radiology, Yamaguchi Grand Hospital, Hofu, Yamaguchi, Japan. 3. Department of Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan.
Abstract
PURPOSE: We aimed to evaluate the usefulness of histograms of lung perfused blood volume (HLPBV) based on the presence of pulmonary thromboembolism (PTE) and the pulmonary embolic burden. METHODS: A total of 168 patients (55 males; mean age, 62.9 years) underwent contrast-enhanced dual-energy computed tomography (DECT) between January 1 2012 and October 31 2014. Initial DECT images were three-dimensionally reconstructed, and the HLPBV patterns were divided into three types, including the symmetric type (131 patients, 78.0%), gradual type (25 patients, 14.9%), and asymmetric type (12 patients, 7.1%). RESULTS: Acute PTE was diagnosed in all 12 patients with asymmetric type (100%), 19 of the 25 patients with gradual type (76%) and 24 of the 131 patients with symmetric type (18.3%). HLPBV pattern exhibited correlations with the right/left ventricular diameter ratio (r=0.36, P = 0.007) and CT obstruction index (r=0.63, P < 0.001) in patients with PTEs. When the gradual and asymmetric types were regarded as positive for PTE, the specificity, positive predictive value, negative predictive value, and accuracy were 92.9%, 83.8%, 87.6%, and 81.0%, respectively. CONCLUSION: Histogram-pattern analysis using DECT might be a useful application to diagnose PTE.
PURPOSE: We aimed to evaluate the usefulness of histograms of lung perfused blood volume (HLPBV) based on the presence of pulmonary thromboembolism (PTE) and the pulmonary embolic burden. METHODS: A total of 168 patients (55 males; mean age, 62.9 years) underwent contrast-enhanced dual-energy computed tomography (DECT) between January 1 2012 and October 31 2014. Initial DECT images were three-dimensionally reconstructed, and the HLPBV patterns were divided into three types, including the symmetric type (131 patients, 78.0%), gradual type (25 patients, 14.9%), and asymmetric type (12 patients, 7.1%). RESULTS: Acute PTE was diagnosed in all 12 patients with asymmetric type (100%), 19 of the 25 patients with gradual type (76%) and 24 of the 131 patients with symmetric type (18.3%). HLPBV pattern exhibited correlations with the right/left ventricular diameter ratio (r=0.36, P = 0.007) and CT obstruction index (r=0.63, P < 0.001) in patients with PTEs. When the gradual and asymmetric types were regarded as positive for PTE, the specificity, positive predictive value, negative predictive value, and accuracy were 92.9%, 83.8%, 87.6%, and 81.0%, respectively. CONCLUSION: Histogram-pattern analysis using DECT might be a useful application to diagnose PTE.
Authors: Martine Remy-Jardin; Massimo Pistolesi; Lawrence R Goodman; Warren B Gefter; Alexander Gottschalk; John R Mayo; H Dirk Sostman Journal: Radiology Date: 2007-09-11 Impact factor: 11.105
Authors: Sven F Thieme; Thorsten R C Johnson; Christopher Lee; Justin McWilliams; Christoph R Becker; Maximilian F Reiser; Konstantin Nikolaou Journal: AJR Am J Roentgenol Date: 2009-07 Impact factor: 3.959