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. 2014 Aug;203(2):287-91.
doi: 10.2214/AJR.13.11586.

Quantification of lung perfusion blood volume with dual-energy CT: assessment of the severity of acute pulmonary thromboembolism

Ayami Sakamoto  1 , Ichiro Sakamoto, Hiroki Nagayama, Hirofumi Koike, Eijun Sueyoshi, Masataka Uetani
Affiliations

Quantification of lung perfusion blood volume with dual-energy CT: assessment of the severity of acute pulmonary thromboembolism

Ayami Sakamoto et al. AJR Am J Roentgenol. 2014 Aug.

Abstract

Objective: The purpose of this study was to evaluate the usefulness of quantification of lung perfused blood volume (PBV) with dual-energy CT (DECT) for assessment of the severity of acute pulmonary thromboembolism (PTE).

Materials and methods: We retrospectively analyzed the records of 72 patients with PTE and 168 without PTE who underwent DECT. The PTE patients were divided into high-, intermediate-, and low-risk groups based on clinical symptoms and right ventricular dysfunction. Correlations between quantification of whole-lung PBV and clinical severity were evaluated. Also evaluated was the relation between quantification of whole-lung PBV and right-to-left ventricular diameter ratio on CT images, which was used as an indicator of right ventricular dysfunction.

Results: In the PTE and control groups, the whole-lung PBVs were 27.6 ± 7.9 and 29.9 ± 6.8 HU with a significant difference between them (p < 0.0281). In the high-, intermediate-, and low-risk PTE groups, the whole-lung PBVs were 16.0 ± 2.9, 21.0 ± 4.2, and 31.4 ± 5.8 HU with a significant difference between them (p < 0.05). There was no significant difference in whole-lung PBV between the control group and the low-risk PTE group, but there was a significant difference between the control group and the other two PTE groups. In PTE patients, whole-lung PBV had negative correlation with right-to-left ventricular diameter ratio (R = -0.567, p < 0.001).

Conclusion: Quantification of lung PBV with DECT is useful for assessment of the clinical severity of PTE and can be used as an indicator of right ventricular dysfunction.

Keywords: dual-energy CT; lung perfusion blood volume; pulmonary CT angiography; pulmonary thromboembolism; severity assessment.

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