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Different Perfusion Pattern Between Acute and Chronic Pulmonary Thromboembolism: Evaluation With Two-Phase Dual-Energy Perfusion CT Read More: http://www.ajronline.org/doi/abs/10.2214/AJR.12.8697

Authors
 Yoo Jin Hong  ;  Ja Young Kim  ;  Kyu Ok Choe  ;  Jin Hur  ;  Hye-Jeong Lee  ;  Byoung Wook Choi  ;  Young Jin Kim 
Citation
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.200(4) : 812-817, 2013 
Journal Title
 AMERICAN JOURNAL OF ROENTGENOLOGY 
ISSN
 0361-803X 
Issue Date
2013
MeSH
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Iopamidol ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Embolism/diagnostic imaging* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods*
Keywords
acute thromboembolic disease ; chronic thromboembolic disease ; dual-energy CT ; pulmonary perfusion ; pulmonary thromboembolism
Abstract
OBJECTIVE: The purpose of this study was to evaluate whether two-phase dual-energy CT can differentiate between lung perfusion patterns of patients with chronic pulmonary thromboembolism (PTE) and those of patients with acute PTE. SUBJECTS AND METHODS: A total of 114 patients clinically suspected to have PTE were prospectively enrolled. All patients underwent dual-energy CT at pulmonary artery (PA) and delayed phases. Of 68 patients diagnosed with PTE on CT, 42 were finally included. Iodine-related attenuation values (IRAs) were measured in PA and delayed phases for each lung segment, and IRA change ratios were calculated using the formula 100% × [(IRA of delayed phase) - (IRA of PA phase)]/(IRA of PA phase). RESULTS: Among the 42 patients (19 men and 23 women; mean age, 60.3 ± 13.2 years; range, 28-82 years), 24 had a diagnosis of acute PTE and 18 of chronic PTE. Those segments with both perfusion and filling defects (n = 143) in patients with acute PTE showed no significant changes of mean IRA between PA and delayed phases, whereas the segments from patients with chronic PTE (n = 94) showed significantly increased IRA on delayed phase as compared with PA phase. The mean IRA change ratios in acute and chronic PTE were -3.14% and 191.9%, respectively (p < 0.0001). CONCLUSION: Chronic PTE segments were significantly more enhanced on the delayed phase of two-phase dual-energy CT images than were acute PTE segments, possibly resulting from more extensive systemic collateral formation in chronic PTE. Two-phase dual-energy CT can be used to differentiate distinct regional perfusion patterns between acute and chronic PTE.
Full Text
http://www.ajronline.org/doi/abs/10.2214/AJR.12.8697
DOI
10.2214/AJR.12.8697
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Ja Young(김자영)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Choe, Kyu Ok(최규옥)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87077
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