Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy.

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Abstrakt

Tytuł:: Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy.
Autorzy:: Dournes G; CHU Bordeaux, Department of Medical Imaging, Hôpital Haut-Lévêque, Avenue de Magellan, 33600, Pessac, France.
Verdier D
Montaudon M
Bullier E
Rivière A
Dromer C
Picard F
Billes MA
Corneloup O
Laurent F
Lederlin M
Źródło:: European radiology [Eur Radiol] 2014 Jan; Vol. 24 (1), pp. 42-51. Date of Electronic Publication: 2013 Aug 28.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Berlin : Springer International, c1991-
MeSH Terms:: Angiography/*methods
Hypertension, Pulmonary/*diagnostic imaging
Perfusion Imaging/*methods
Pulmonary Embolism/*diagnostic imaging
Tomography, X-Ray Computed/*methods
Aged ; Chronic Disease ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hypertension, Pulmonary/etiology ; Male ; Pulmonary Embolism/complications ; Reproducibility of Results ; Retrospective Studies
References:: AJR Am J Roentgenol. 2010 Nov;195(5):W325-30. (PMID: 20966296)
N Engl J Med. 2004 May 27;350(22):2257-64. (PMID: 15163775)
Radiol Clin North Am. 2010 Jan;48(1):193-205. (PMID: 19995637)
J Cardiovasc Comput Tomogr. 2011 Jan-Feb;5(1):3-11. (PMID: 21051309)
Eur J Radiol. 2011 Sep;79(3):467-72. (PMID: 20488639)
Eur J Radiol. 2012 Feb;81(2):360-5. (PMID: 21185141)
Eur J Radiol. 2009 Jul;71(1):49-54. (PMID: 18462902)
Eur Respir J. 2013 Mar;41(3):735-42. (PMID: 23143539)
J Comput Assist Tomogr. 2009 Nov-Dec;33(6):981-6. (PMID: 19940672)
J Thorac Imaging. 2009 May;24(2):152-9. (PMID: 19465844)
Am J Respir Crit Care Med. 2011 Jun 15;183(12):1605-13. (PMID: 21330453)
Eur Radiol. 2012 Mar;22(3):607-16. (PMID: 21947513)
AJR Am J Roentgenol. 2009 Jul;193(1):144-9. (PMID: 19542406)
AJR Am J Roentgenol. 2011 Mar;196(3):524-32. (PMID: 21343493)
Chest. 2008 Mar;133(3):646-52. (PMID: 18198257)
Radiology. 1992 Feb;182(2):393-8. (PMID: 1732955)
Acad Radiol. 2008 Dec;15(12):1494-504. (PMID: 19000866)
J Thorac Imaging. 2004 Apr;19(2):67-73. (PMID: 15071321)
Nucl Med Commun. 2012 May;33(5):459-63. (PMID: 22262242)
J Comput Assist Tomogr. 2011 Sep-Oct;35(5):590-5. (PMID: 21926854)
Rofo. 2008 Oct;180(10):879-83. (PMID: 19238637)
Chest. 2005 May;127(5):1606-13. (PMID: 15888835)
Eur Heart J. 2009 Oct;30(20):2493-537. (PMID: 19713419)
Chest. 2013 Apr;143(4):1070-1077. (PMID: 23100061)
Radiology. 2005 Apr;235(1):274-81. (PMID: 15703314)
Eur Heart J. 2008 Sep;29(18):2276-315. (PMID: 18757870)
J Nucl Med. 2007 May;48(5):680-4. (PMID: 17475953)
Radiology. 1997 Sep;204(3):695-702. (PMID: 9280245)
Eur J Radiol. 2011 Dec;80(3):e476-82. (PMID: 20943337)
Eur Radiol. 2007 Jun;17(6):1510-7. (PMID: 17151859)
Entry Date(s):: Date Created: 20130829 Date Completed: 20141021 Latest Revision: 20220321
Update Code:: 20240104
DOI:: 10.1007/s00330-013-2975-y
PMID:: 23982287
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Objectives: To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy.
Methods: Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated.
Results: Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively.
Conclusions: Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities.
Key Points: • Chronic thromboembolic pulmonary hypertension (CTEPH) is potentially treatable by surgery. • Dual-energy computed tomography (DECT) allows angiography and perfusion using a single acquisition. • Both DECT perfusion and angiography showed satisfactory diagnostic performance in CTEPH. • DECT perfusion was more accurate than angiography in identifying segmental abnormalities.

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