摘要
目的:动态观察家兔急性肺栓塞双源CT双能量肺灌注成像表现及其病理学基础,评价双源CT双能量肺灌注成像诊断家兔急性肺栓塞的价值。方法:经股静脉入路注入明胶海绵制作24只家兔急性肺栓塞模型,随机分成4组(即2h组、1天组、3天组和7天组),每组6只。家兔栓塞前及栓塞后2h、1天、3天和7天行双源CT平扫和双能量扫描。采用双能量软件(Lung PBV)进行数据分析处理,分别得到CT解剖图像(CTPA)、双能量肺灌注图像(DEPI)及两者融合图像。以肺叶为单位,分析栓塞前及栓塞后各时间点的肺灌注影像表现,并记录栓塞后肺内灌注异常的肺叶数目;进行家兔肺大体解剖和镜下观察,记录肺栓塞部位及病理表现。以病理为金标准,计算DEPI、CTPA及融合图像诊断肺栓塞的准确性。结果:栓塞前家兔双能量肺灌注图像表现为大致均匀的黄红色伪彩。栓塞后2h组肺灌注图像显示栓塞区呈蓝色;1天组及3天组栓塞区呈蓝黑色;7天组栓塞区呈黑色。DEPI和CTPA诊断肺栓塞的敏感度、特异度、阳性预测值(PPV)和阴性预测值(NPV)分别为100%、95%、95%和100%以及98%、100%、100%和99%;2项指标与病理结果吻合度强(Kappa值=0.933),融合图像与DEPI一致性好。结论:采用双源CT双能量肺灌注成像技术可观察肺栓塞后肺实质动态灌注变化,并与病理结果有很高的一致性。
Objective：To observe dynamic changes of lung perfusion of the acute PE and to compare with the gold standard in pathology, to evaluate dual-energy perfusion imaging for diagnosing acute PE by using dual-source CT. Methods： 24 experimental rabbit models of acute pulmonary embolism were established via femoral vein using gelatin sponge as embolus materials, which were randomly divided into 4 groups （i. e. group 2h, ld, 3d, and 7d, n= 6, respectively）. Standard nonenhanced and contrast enhanced dual source CT scanning with dual energy mode were performed pre-and post-embolization 2h, l d, 3d, 7d. All images including pre-and post embolization were analyzed by lung PBV software. CTPA, dual energy perfusion imaging （DEPI）,and fusion images were obtained. To observe the dynamic changes of lung perfusion, the numbers and locations of PE in DEPI,CTPA, and fusion images were recorded in a per lobe basis;The location and number of the embolism in these slices were recorded. With the pathology results as the reference standards, sensitivity, specificity, PPV, and NPC of CTPA, DEPI, and fusion images were measured. Results：Before embolization on the DEPI, lung appeared as uniform red pseudo-color, at 2h after embolization, the embolie lung tissue showed blue, at ld and 3d, blue and black; 7 day, black. Comparing to pathology as a standard of reference, sensitivity, specificity, PPV, and NPV of CTPA, DEPI, and fused images were 100%,95 %, 95%, and 100%, 98%, 100%, 100%, and 99%, respectively. Conclusion： Dual-energy lung perfusion imaging of DSCT can display the dynamic changes of the lung perfusion after PE,which has a high diagnostic sensitivity in assessment of acute pulmonary embolism.
出处
《放射学实践》
北大核心
2010年第3期258-262,共5页
Radiologic Practice
基金
南京军区南京总医院院内青年基金课题资助(Q2008062)
关键词
肺栓塞
肺灌注成像
双源CT
动物模型
Pulmonary embolism
Pulmonary perfusion imaging
Dual-source computed tomography
Animal model
