Published in:
01-10-2013 | Chest
Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism
Published in: European Radiology | Issue 10/2013
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Objectives
To evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE).
Methods
This 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.
Results
Of 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).
Conclusions
DECT 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.