scholarly journals Analysis of the iodine distribution map in patients with diagnosis of pulmonary embolism: Initial results

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.  

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 870
Author(s):  
Saif Afat ◽  
Ahmed E. Othman ◽  
Konstantin Nikolaou ◽  
Sebastian Gassenmaier

To evaluate contrast-enhanced dual-energy computed tomography (DECT) chest examinations regarding pulmonary perfusion patterns and pulmonary opacities in patients with confirmed COVID-19 disease. Fourteen patients with 24 DECT examinations performed between April and May 2020 were included in this retrospective study. DECT studies were assessed independently by two radiologists regarding pulmonary perfusion defects, using a Likert scale ranging from 1 to 4. Furthermore, in all imaging studies the extent of pulmonary opacities was quantified using the same rating system as for perfusion defects. The main pulmonary findings were ground glass opacities (GGO) in all 24 examinations and pulmonary consolidations in 22 examinations. The total lung scores after the addition of the scores of the single lobes showed significantly higher values of opacities compared to perfusion defects, with a median of 12 (9–18) for perfusion defects and a median of 17 (15–19) for pulmonary opacities (p = 0.002). Furthermore, mosaic perfusion patterns were found in 19 examinations in areas with and without GGO. Further studies will be necessary to investigate the pathophysiological background of GGO with maintained perfusion compared to GGO with reduced perfusion, especially regarding long-term lung damage and prognosis.


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

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.


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

2020 ◽  
Author(s):  
Lixin Yang ◽  
Jihang Sun ◽  
Jiangying Li ◽  
Tong Yu ◽  
Bei Wang ◽  
...  

Abstract Background: Pulmonary embolism (PE) associated with Mycoplasma pneumoniae pneumonia (MPP) in children has already attracted more attention. We aimed to evaluate the application of dual-energy spectral CT in diagnosing PE in children with MPP.Methods: Eight-three children with MPP and highly suspected PE, underwent CT pulmonary angiography (CTPA) with spectral imaging mode. Noise, clot-to-artery contrast-to-noise ratio, image quality and diagnosis confidence were calculated and assessed on nine monochromatic image sets (40 to 80keV). CTPA images were observed for the presence, localization, and embolic degrees of PE. Emboli were divided between intra and extra-consolidation. For extra-consolidation clots, iodine concentration (IC) of perfusion defects and normal lung, perfusion defects of 4 children before and after the treatment were measured and compared. For intra-consolidation clots, IC of consolidation areas with clots and consolidation areas without clot were measured and compared.Results: The optimal energy level for detecting PE in children was 55 keV. 116 clots (29 extra consolidations) were found in 25 children, IC of defect regions associated with PE was 0.69±0.28mg/mL (extra-consolidations) and 0.90±0.23mg/mL (intra-consolidations), both significantly lower than the 2.76±0.45mg/mL in normal lungs and 10.25±1.76mg/mL in consolidations without clots (P<0.001). Significant difference was found in the presence or absence of perfusion defects between occlusive clots and nonocclusive clots(P<0.001). IC of the perfusion defects significantly increased after treatment (P<0.001).Conclusions: In spectral CTPA 55 keV images optimize PE detection for children. and MD images quantify pulmonary blood flow of PE, and may help to detect small clots and quantify embolic degrees.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghao Chen ◽  
Jie Zhou ◽  
Jushun Yang ◽  
Ruochen Cong ◽  
Jinjie Sun ◽  
...  

Abstract Background This retrospective study aimed to investigate the usefulness of the optimized kiloelectron volt (keV) for virtual monoenergetic imaging (VMI) combined with iodine map in dual-energy computed tomography enterography (DECTE) in the diagnosis of Crohn’s disease (CD). Methods Seventy-two patients (mean age: 41.89 ± 17.28 years) with negative computed tomography enterography (CTE) were enrolled for investigating the optimized VMI keV in DECTE by comparing subjective and objective parameters of VMIs that were reconstructed from 40 to 90 keV. Moreover, 68 patients (38.27 ± 15.10 years; 35 normal and 33 CD) were included for evaluating the diagnostic efficacy of DECTE iodine map at the optimized VMI energy level and routine CTE for CD and active CD. Statistical analysis for all data was conducted. Results Objective and subjective imaging evaluations showed the best results at 60 keV for VMIs. The CT values of the normal group, active subgroup, and CD group during the small intestinal phase at routine 120 kVp or 60 keV VMI had significant differences. The diagnostic efficacy of an iodine map was the best when NIC = 4% or fat value = 45.8% for CD, whereas NIC < 0.35 or the fat value < 0.38 for active CD. The combined routine CTE and optimized VMI improved the diagnostic efficacy (P < 0.001). Conclusions VMI at 60 keV provided the best imaging quality on DECTE. NIC and fat value provided important basis for active CD evaluation. Routine CTE combined with VMI at 60 keV improved the diagnostic efficiency for CD.


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