title: Lung perfusion with dual-energy multidetector-row CT (MDCT): feasibility for the evaluation of acute pulmonary embolism in 117 consecutive patients.
abstract: OBJECTIVE
  To investigate the accuracy of dual-energy computed tomography in the depiction of perfusion defects in patients with acute pulmonary embolism (PE).
  
  
  METHODS
  One hundred seventeen consecutive patients with clinical suspicion of acute PE underwent dual-energy multidetector computed tomographic (CT) angiography of the chest with a standard injection protocol. Two radiologists evaluated, by consensus, the presence of endoluminal clots on (1) transverse "diagnostic" scans (contiguous 1-mm-thick averaged images from tubes A and B) and (2) lung perfusion scans.
  
  
  RESULTS
  Seventeen patients showed CT features of acute PE, with the depiction of 75 clots within the lobar (n = 15), segmental (n = 43) and subsegmental (n = 17) pulmonary arteries. A total of 17 clots were identified as complete filling defects (ie, obstructive clots), located within segmental (12 of 17) and subsegmental (5 of 17) arteries. Fourteen of the 17 obstructive clots were seen with the concurrent presence of corresponding perfusion defects, whereas cardiac motion and/or contrast-induced artifacts precluded the confident recognition of perfusion abnormalities in the remaining two segments and one subsegment. Four subsegmental perfusion defects were depicted without the visualization of endoluminal thrombi within the corresponding arteries. Perfusion defects were identified beyond five nonobstructive clots.
  
  
  CONCLUSIONS
  Simultaneous information on the presence of endoluminal thrombus and lung perfusion impairment can be obtained with dual-energy computed tomography.
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Boulevard Jules Leclercq, 59037 Lille cedex, France.
authors.forename: François
authors.initials: F
authors.lastname: Pontana
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Faivre
authors.forename: Martine
authors.initials: M
authors.lastname: Remy-Jardin
authors.forename: Thomas
authors.initials: T
authors.lastname: Flohr
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schmidt
authors.forename: Nunzia
authors.initials: N
authors.lastname: Tacelli
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pansini
authors.forename: Jacques
authors.initials: J
authors.lastname: Remy
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000295:instrumentation / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult