• European radiology · Oct 2013

    Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism.

    • Long Jiang Zhang, Chang Sheng Zhou, U Joseph Schoepf, Hui Xue Sheng, Sheng Yong Wu, Aleksander W Krazinski, Justin R Silverman, Felix G Meinel, Yan E Zhao, Zong Jun Zhang, and Guang Ming Lu.
    • Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China.
    • Eur Radiol. 2013 Oct 1;23(10):2666-75.

    ObjectivesTo evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE).MethodsThis study was institutional review board-approved and written informed consent was obtained from each patient. Thirty-two subjects (aged 11-61 years) underwent combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT. Ventilation, perfusion and morphological information were visually interpreted. Ventilation/perfusion information was classified as mismatch (differing patterns) or match (concordant patterns). Adverse reactions and radiation doses were recorded for each subject.ResultsOf 32 patients undergoing xenon-enhanced DECT, six patients reported adverse reactions (shortness of breath, n = 2; mild dizziness, n = 3; limb numbness, n = 1). Twenty-eight of 32 patients could be included into the data analysis. PE was detected in 10/28 patients. PE-related ventilation/perfusion mismatch was found in 17 lung lobes in 8/10 patients and matched ventilation/perfusion was detected in 2 patients. Eighteen patients had no PE. In this group, there was no case of a ventilation/perfusion mismatch. Matched ventilation/perfusion impairment was seen in one patient. The overall radiation dose from two DECT acquisitions was 4.8 ± 1.4 mSv (range 2.7-7.5 mSv).ConclusionsDECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/perfusion match or mismatch in patients with suspected PE.Key Points• Combined dual-energy CT lung ventilation/perfusion imaging is feasible. • Combined dual-energy CT ventilation/perfusion imaging provides lung morphological and functional information. • Dual-energy CT can demonstrate ventilation/perfusion mismatch in patients with pulmonary embolism.

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