CT perfusion image of the lung - Value in the detection of pulmonary embolism in a porcine model

被引:17
作者
Chung, MJ
Goo, JM
Im, JG
Lee, KS
Kim, KG
Park, JH
机构
[1] Seoul Natl Univ, Coll Med, Dept Radiol, Seoul, South Korea
[2] SNUMRC, Clin Res Inst, Inst Radiat Med, Seoul, South Korea
[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Radiol, Seoul, South Korea
[4] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Ctr Imaging Sci, Seoul, South Korea
关键词
pulmonary embolism; animal studies; computed tomography; lung perfusion;
D O I
10.1097/01.rli.0000138672.35942.49
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Rationale and Objectives: We assess the value of computed tomography perfusion image (CTPI) obtained by postprocessing the CT data in the diagnosis of pulmonary embolism. Methods: An experimental pulmonary embolism model was made in 6 pigs by injecting 2 types of emboli into the pulmonary arteries. For each pig, 5 type-A (o3.5 X 8 mm) and 5 type-B (o2.5 X 6 mm) emboli were injected through a catheter with the distal tip located in the inflow tract of the right atrium. After obtaining precontrast and postcontrast CT data during a single breath-hold using a 4-slice multidetector CT, perfusion images were generated by data subtraction. Approximately 150 to 180 mL of contrast material was injected at an injection rate of 6 mL/s to obtain postcontrast CT. Three independent observers twice analyzed CT images for the presence of emboli: once with postcontrast CT scans (CT angiography: CTA) alone and again with both CTA and CTPI. The locations of the emboli in the pulmonary arteries were confirmed by examining the killed porcine lungs. Results: The sensitivity and positive predictive value in the detection of pulmonary emboli with CTA alone were 59% (106/180) and 87% (106/122), respectively. The sensitivity and positive predictive value with both CTA and CTPI were 87% (156/180) and 85% (156/184), respectively. For type-A emboli, the sensitivity with both CTA and CTPI (76/90, 85%) was better than that with CTA alone (63/90, 70%) (P < 0.001). For type-B emboli, the sensitivity with both CTA and CTPI (80/90, 89%) was also better than that of CTA alone (43/90, 48%) (P < 0.001). Conclusions: CTPI could be obtained using digital subtraction of the CT data. It appeared to be an adjunct in enhancing the diagnostic accuracy of pulmonary embolism, particularly when detecting small pulmonary emboli.
引用
收藏
页码:633 / 640
页数:8
相关论文
共 29 条
[1]  
Aviram Galit, 2004, Curr Probl Diagn Radiol, V33, P74, DOI 10.1016/j.cpradiol.2003.11.001
[2]   Lung perfusion demonstrated by contrast-enhanced dynamic magnetic resonance imaging - Application to unilateral lung transplantation [J].
Berthezene, Y ;
Croisille, P ;
Bertocchi, M ;
Houzard, C ;
Bendib, K ;
Revel, D .
INVESTIGATIVE RADIOLOGY, 1997, 32 (06) :351-356
[3]   SEGMENTATION AND ESTIMATION OF IMAGE REGION PROPERTIES THROUGH COOPERATIVE HIERARCHIAL COMPUTATION [J].
BURT, PJ ;
HONG, TH ;
ROSENFELD, A .
IEEE TRANSACTIONS ON SYSTEMS MAN AND CYBERNETICS, 1981, 11 (12) :802-809
[4]   Time-resolved three-dimensional pulmonary MR angiography and perfusion imaging with ultrashort repetition time [J].
Carr, JC ;
Laub, G ;
Zheng, J ;
Pereles, FS ;
Finn, JP .
ACADEMIC RADIOLOGY, 2002, 9 (12) :1407-1418
[5]   Diagnosis of acute pulmonary embolism in outpatients: Comparison of thin-collimation multi-detector row spiral CT and planar ventilation-perfusion scintigraphy [J].
Coche, E ;
Verschuren, F ;
Keyeux, A ;
Goffette, P ;
Goncette, L ;
Hainaut, P ;
Hammer, F ;
Lavenne, E ;
Zech, F ;
Meert, P ;
Reynaert, MS .
RADIOLOGY, 2003, 229 (03) :757-765
[6]   Acute pulmonary embolism: Ancillary findings at spiral CT [J].
Coche, EE ;
Muller, NL ;
Kim, KI ;
Wiggs, BR ;
Mayo, JR .
RADIOLOGY, 1998, 207 (03) :753-758
[7]   Image analysis in multiplanar spiral CT of the lung with MPR and MIP reconstructions [J].
Eibel, R ;
Brüning, R ;
Schöpf, UJ ;
Leimeister, P ;
Stadie, A ;
Reiser, MF .
RADIOLOGE, 1999, 39 (11) :952-957
[8]   Regional lung perfusion:: Assessment with partially parallel three-dimensional MR imaging [J].
Fink, C ;
Puderbach, M ;
Bock, M ;
Lodemann, KP ;
Zuna, I ;
Schmähl, A ;
Delorme, S ;
Kauczor, HU .
RADIOLOGY, 2004, 231 (01) :175-184
[9]   Partially parallel three-dimensional magnetic resonance imaging for the assessment of lung perfusion -: Initial results [J].
Fink, C ;
Bock, M ;
Puderbach, M ;
Schmähl, A ;
Delorme, S .
INVESTIGATIVE RADIOLOGY, 2003, 38 (08) :482-488
[10]   Use of high concentration contrast media: principles and rationale - vascular district [J].
Fleischmann, D .
EUROPEAN JOURNAL OF RADIOLOGY, 2003, 45 :S88-S93