Iodine Distribution Map in Dual-Energy Computed Tomography Pulmonary Artery Imaging with Rapid kVp Switching for the Diagnostic Analysis and Quantitative Evaluation of Acute Pulmonary Embolism

2015 ◽  
Vol 22 (6) ◽  
pp. 743-751 ◽  
Author(s):  
Xiang-Ran Cai ◽  
You-Zhen Feng ◽  
Lin Qiu ◽  
Zhao-Hui Xian ◽  
Wen-Cai Yang ◽  
...  
2020 ◽  
pp. 084653712090206 ◽  
Author(s):  
Waleed Abdellatif ◽  
Mahmoud Ahmed Ebada ◽  
Souad Alkanj ◽  
Ahmed Negida ◽  
Nicolas Murray ◽  
...  

Purpose: In this systematic review and meta-analysis, we aimed to investigate the accuracy of dual-energy computed tomography (DECT) in the detection of acute pulmonary embolism (PE). Methods: We searched Medline (via PubMed), EBSCO, Web of Science, Scopus, and the Cochrane Library for relevant published studies. We selected studies assessing the accuracy of DECT in the detection of PE. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 tool. Meta-analysis was performed to calculate mean estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). The summary receiver operating characteristic (sROC) curve was drawn to get the Cochran Q-index and the area under the curve (AUC). Results: Seven studies were included in our systematic review. Of the 182 patients included, 108 patients had PEs. The pooled analysis showed an overall sensitivity and specificity of 88.9% (95% confidence interval [CI]: 81.4%-94.1%) and 94.6% (95% CI: 86.7%-98.5%), respectively. The pooled PLR was 8.186 (95% CI: 3.726-17.986), while the pooled NLR was 0.159 (95% CI: 0.093-0.270). Cochran-Q was 0.8712, and AUC was 0.935 in the sROC curve. Conclusion: Dual-energy computed tomography shows high sensitivity, specificity, and diagnostic accuracy in the detection of acute PE. The high PLR highlights the high clinical importance of DECT as a prevalence-independent, rule-in test. Studies with a larger sample size with standardized reference tests are still needed to increase the statistical power of the study and support these findings.


2021 ◽  
Vol 7 (1) ◽  
pp. 21-33
Author(s):  
Cecilia Muñoz ◽  
Anghelo Silencio ◽  
Isna Larico

Objectives: Analysing the iodine map distribution in patients with pulmonary embolism diagnosis by Dual Energy Computed Tomography. Materials and methods: Twenty-four images of pulmonary angiotomography by dual energy computed tomography were used to determinate the presence of pulmonary thrombi and identify the perfusion defects (PDs) in the Iodine Maps. Moreover, the iodine density (mg/ml) were measured in normal lung parenchyma and lung parenchyma with PDs areas. The documentary analysis was used thought the data collection sheet and the Likert scale questionnaire. The statistic software SPSS v.25 was used. Results: Thirty-four thrombi were found (21 occlusive and 13 partials occlusive) at monochromatic images. Forty-one perfusion defects (PD) were found at Iodine Maps, these have multiple origins: pulmonary thrombi (69.23%), artifacts (17.95%) and other alterations (12.82%). Furthermore, two new thrombi (5.56%) were identified, both were occlusive and segmental level. Mean Iodine density showed statistically significant differences among normal lung parenchyma (1.65 ± 0.66 mg/ml; [0.77-2.79 mg/ ml]) and parenchyma with PD areas (0.51 ± 0.26 mg/ml; [0.12-1.02 mg/ml])(p=0.000). Mean iodine density also had statistically significant differences between parenchyma with occlusive PD and partial occlusive PD (p=0.000). Iodine Map diagnostic quality was excellent (54.17%), good (33.33%), moderate (12.50%). Conclusion: The Iodine distribution Map offers a benefit greater than 5% in the diagnosis of pulmonary embolism by Dual-Energy Computed Tomography.  


10.5772/31720 ◽  
2012 ◽  
Author(s):  
YanE Zhao ◽  
Long Jiang ◽  
Guang Ming ◽  
Kevin P. ◽  
U. Joseph

2009 ◽  
Vol 50 (8) ◽  
pp. 892-901 ◽  
Author(s):  
Long Jiang Zhang ◽  
Gui Fen Yang ◽  
Yan E. Zhao ◽  
Chang Sheng Zhou ◽  
Guang Ming Lu

2010 ◽  
Vol 83 (992) ◽  
pp. 707-718 ◽  
Author(s):  
G-M Lu ◽  
S-Y Wu ◽  
B M Yeh ◽  
L-J Zhang

2017 ◽  
Vol 26 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Muthiah Subramanian ◽  
Srinivasan Ramadurai ◽  
Preetam Arthur ◽  
Sowmya Gopalan

Background The purpose of this study was to investigate the correlation between the computed tomography pulmonary artery obstruction index and parameters of functional lung impairment in acute pulmonary embolism, and establish the value of these parameters in prognosticating right ventricular dysfunction and 30-day mortality. Methods This study included 322 consecutive patients (mean age 45.6 ± 13.2 years, 46.9% male) with acute pulmonary embolism, free of other cardiopulmonary disease, who underwent computed tomography pulmonary angiography. Correlations of arterial CO2, O2, and alveolar-arterial oxygen gradient with the computed tomography pulmonary artery obstruction index, measured using the Qanadli score, were analyzed. Logistic regression was used to identify independent predictors of right ventricular dysfunction and 30-day mortality. Results Of the 322 patients, 196 (60.9%) had right ventricular dysfunction, and 58 (18.0%) died within 30 days. The pulmonary artery obstruction index had a significant correlation with partial pressures of arterial O2 ( r = −0.887, p < 0.001) and CO2 ( r = −0.618, p = 0.019) and alveolar-arterial oxygen gradient ( r = +0.874, p < 0.001). Arterial O2 pressure had a good predictive accuracy and discriminative power for both right ventricular dysfunction (sensitivity 80.6%, specificity 85.1%, area under the curve 0.91) and 30-day mortality (sensitivity 77.8%, specificity 82.0%, area under the curve 0.89). Conclusions In patients with acute pulmonary embolism, free of other cardiopulmonary disease, parameters of functional impairment have a strong correlation with computed tomography pulmonary artery obstruction index. Hypoxia is an independent predictor of both right ventricular dysfunction and 30-day mortality in these patients.


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