Keywords:
Embolism / Thrombosis, Diagnostic procedure, Computer Applications-Detection, diagnosis, CT-Angiography, Vascular, Thorax, Pulmonary vessels
Authors:
A. B. Aydemir, M. M. Keleş, N. Erdogan, E. CINDIL, G. Erbas, H. N. SENDUR, M. Cerit, H. K. Kilic, M. Arac; ANKARA/TR
DOI:
10.26044/ecr2019/C-2902
Aims and objectives
Pulmonary embolism (PE) is a common cardiovascular emergency and has a high mortality ratio.
Early diagnose is critical for management of PE.
After physical examination and assessing blood D-dimer levels,
it is appropriate to perform lower extremity Doppler ultrasound,
ventilation perfusion scintigraphy,
invasive angiography and pulmonary computed tomography angiography (PCTA) for imaging of clinically suspicious patients to diagnosis.
It is known that PCTA is gold standard imaging modality for diagnosis because of high sensitivity and specificity (1,
2,
3 ).
Most prominent PCTA finding of acute PE is complete arterial occlusion with increased diameter of vessel.
However,
acute PE may also cause partial filling defects,
which settle at the central of vessel or at eccentric location with acute angle.
Also chronic PE can cause total occlusion of vessel lumen but with decreased in size of vessel.
It can cause web like or eccentric partial filling defects with obtuse angle.
But it is known that PCTA has low sensitivity for subsegmental pulmonary arterial embolism because of small size of vessels and spatial resolution of technique.
( 2,
3,
4).
Dual energy CT provides multienergetic imaging potential together and with this method It’s possible to create iodine map and calculate iodine concentration at any voxel.
These findings represent microcirculation of lung.
Pulmonary emboli cause perfusion defect in certain lung areas at iodine maps.
Also some researches show that it is more useful and provide better evaluation for subsegmental pulmonary arter territories.
(5,
6,
7).
It is known that radiation dose of dual-energy pulmonary CT was not higher than that of conventional single-source
CTPA.
Lung perfusion images can be better than PCTA to evaluation of small vessels occlusion (8,
9,
10).
The purpose of this study is to investigate the accuracy of iodine maps alone compared to PCTA.