摘要
目的:探讨双能CT低剂量扫描在肺栓塞诊断中的应用价值。方法:选取2024年3月至2025年3月本院收治的100例疑似肺栓塞患者,均接受双能CT低剂量及CT肺动脉造影(CTPA)检查。以CTPA结果为参考标准,分析双能CT低剂量扫描检查在肺栓塞中的诊断效能及安全性,并探讨其影像学特征。结果:CTPA结果显示,100例患者中肺栓塞72例(72.00%),非肺栓塞28例(28.00%)。双能CT低剂量扫描肺栓塞检出70例,非肺栓塞检出25例,漏诊2例,误诊3例。其准确率、灵敏度、特异度、阳性预测值、阴性预测值分别为95.00%、97.22%、89.29%、95.89%、92.59%,Kappa值为0.846。两组CT、SNR、CNR对比无差异(P>0.05),而双能CT低剂量的DLP、CTDIvol、ED低于CTPA扫描模式(P<0.05)。肺栓塞组肺动脉低密度血栓影、血管截断、中心肺动脉扩张发生率高于非肺栓塞组(P<0.05)。72例肺栓塞患者中,慢性肺栓塞组21例,急性肺栓塞组51例。急性肺栓塞组患者中心型及完全型充盈缺损、肺动脉管腔增宽发生率高于慢性肺栓塞组,而附壁型充盈缺损、肺动脉管腔闭塞/狭窄、支气管动脉扩张发生率低于慢性肺栓塞组(P<0.05)。结论:双能CT低剂量扫描在肺栓塞中具有较高诊断效能,且有无肺栓塞、急慢性肺栓塞患者的双能CT低剂量扫描影像学特征差异明显,可为疾病鉴别诊断提供依据。
Objective:To investigate the application value of low-dose dual-energy CT(DECT)in the diagnosis of pulmonary embolism(PE).Methods:A total of 100 patients with suspected PE admitted to our hospital between March 2024 and March 2025 were enrolled and underwent both low-dose DECT and conventional CT pulmonary angiography(CTPA).Using CTPA as the reference standard,the diagnostic performance and safety of low-dose DECT for PE were analyzed,and its imaging characteristics were evaluated.Results:CTPA identified PE in 72 patients and excluded it in 28 patients.Low-dose DECT detected 70 cases of PE and 25 non-PE cases,with 2 missed diagnoses and 3 false positives.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of low-dose DECT were 95.00%,97.22%,89.29%,95.89%,and 92.59%,respectively,with a Kappa value of 0.846.There were no significant differences in image noise,signal-to-noise ratio(SNR),or contrast-to-noise ratio(CNR)between the two modalities(P>0.05).However,the dose-length product(DLP),volume CT dose index(CTDIvol),and effective dose(ED)of low-dose DECT were significantly lower than those of standard CTPA(P<0.05).The PE group exhibited higher incidences of low-attenuation thrombi,vessel cutoff,and central pulmonary artery dilation compared to the non-PE group(P<0.05).Among 72 patients with pulmonary embolism,21 were in the chronic pulmonary embolism group and 51 in the acute pulmonary embolism group.The incidence of central and complete filling defects and pulmonary arterial lumen dilatation in the acute pulmonary embolism group was higher than that in the chronic pulmonary embolism group,while the incidence of mural filling defects,pulmonary arterial lumen occlusion/narrowing,and bronchial artery dilation was lower than that in the chronic pulmonary embolism group(P<0.05).Conclusion:Low-dose dual-energy CT demonstrates high diagnostic efficacy for pulmonary embolism.Distinctive imaging features on low-dose DECT allow differentiation not only between PE and non-PE but also between acute and chronic PE,providing valuable evidence for differential diagnosis.
作者
陈佳茜
Chen Jiaqian(Department of Radiology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou Zhejiang,310000,China)
出处
《中外女性健康研究》
2025年第12期188-190,194,共4页
Women's Health Research
关键词
肺栓塞
双能CT
低剂量
CT肺动脉造影
Pulmonary embolism
Dual-energy CT
Low-dose
CT pulmonary angiography
