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目的探讨双源CT双能量肺动脉血管成像在肺动脉栓塞诊断中的应用价值。方法20例怀疑肺动脉栓塞患者行双能量肺动脉血管成像(A组),获得140kV、80kV及两者融合的3组横断面原始图像,将140kV和80kV两组图像输入双能量后处理软件(DE),获得DE灌注图像(DEPI);将融合图像输入三维软件获得血管MPR图像(V-MPR),分析DEPI与V-MPR直接显示栓子的差别及二者结合的优势;回顾分析另16例已确诊肺动脉栓塞患者64层螺旋CT胸部CTA图像(B组),由2位医师对2组血管MPR图像质量进行肉眼观察评价。结果肉眼观察A组与B组图像质量、DEPI与V-MPR图直接显示肺动脉干及叶肺动脉内栓子差异均不明显,直接显示段及亚段肺动脉内栓子差异显著;DEPI中肺动脉干、叶动脉及部分段肺动脉内栓子均引起低灌注区,其余段及亚段肺动脉内栓子未见明显灌注改变。结论DSCT双能量肺动脉血管成像能清晰显示栓子,与64层螺旋CT图像质量无差别,可同时对栓塞后肺组织的血流进行评价。
Objective To investigate the value of double-source CT dual-energy pulmonary arteriography in the diagnosis of pulmonary embolism. Methods Twenty patients suspected of pulmonary embolism underwent dual-energy pulmonary arterial angiography (A group). Three groups of original images of 140kV and 80kV and their fusion were obtained. The two images of 140kV and 80kV were input into dual-energy post-processing software (DE ) To obtain the DE perfusion image (DEPI). The fusion image was input into the 3D software to acquire the vascular MPR image (V-MPR). The difference between DEPI and V-MPR in displaying emboli and the combination of the two were analyzed. Sixty-four-slice CTA images of chest wall in patients with pulmonary embolism have been confirmed (group B). Two physicians evaluated the MPR images of the two groups by visual inspection. Results The image quality of group A and group B was observed by macroscopy. DEPI and V-MPR images showed no significant difference between pulmonary artery and pulmonary artery embolus, which showed significant difference of pulmonary embolism in segment and sub-segment directly. D Pulmonary artery , Leaf arteries and some sections of pulmonary embolism caused by low perfusion area, the rest and sub-pulmonary emboli no significant perfusion change. Conclusions DSCT dual energy pulmonary arterial angiography can clearly show the emboli, which has no difference with 64-slice spiral CT images, and can evaluate the pulmonary blood flow after embolization.