title: Dual-energy CT for differentiating acute and chronic pulmonary thromboembolism: an initial experience.
abstract: The purpose of this study was to prospectively evaluate the diagnostic capability of single-phase dual-energy CT (DECT) angiography to differentiate acute and chronic pulmonary thromboembolism (APTE, CPTE). We prospectively enrolled 26 patients (M:F = 9:17; mean age, 61 years old) with a filling defect in the pulmonary artery on DECT angiography. They were divided into two groups-APTE and CPTE-based on the clinical criteria. Two investigators quantitatively measured the following parameters at the embolism and main pulmonary artery: CT attenuation density [Hounsfield unit (HU) values], iodine-related HU value (IHU), and iodine concentration (IC, mg/ml). These parameters of the embolism and their ratio divided by those of the main pulmonary artery were compared between APTE and CPTE groups. Among 26 patients, 15 were categorized into the APTE group and 11 into the CPTE group. The mean HU, IHU, and IC values of emboli were significantly different between the APTE and CPTE groups (32.2 ± 17.0 vs. 52.1 ± 13.6 HU; P = 0.016, 7.2 ± 2.8 vs. 27.3 ± 12.7 HU; P < 0.001, and 0.57 ± 0.23 vs. 1.56 ± 0.67; P < 0.001). The mean HU, IHU, and IC ratios between emboli and main pulmonary arteries were also significantly different between the two groups (0.085 ± 0.046 vs. 0.156 ± 0.064 HU; P = 0.003, 0.023 ± 0.013 vs. 0.099 ± 0.053; P < 0.001, and 0.048 ± 0.035 vs. 0.130 ± 0.064; P = 0.001). DECT angiography using a quantitative analytic methodology can be used to differentiate between APTE and CPTE.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
authors.forename: Seung-Seob
authors.initials: SS
authors.lastname: Kim
authors.forename: Jin
authors.initials: J
authors.lastname: Hur
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Hong
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007479:Iopamidol
references.citation: Eur Respir J. 2000 Mar;15(3):435-7
references.pmid: 10759432
references.citation: AJR Am J Roentgenol. 1997 Jul;169(1):79-82
references.pmid: 9207504
references.citation: J Thorac Imaging. 2004 Jul;19(3):164-70
references.pmid: 15273612
references.citation: J Thorac Imaging. 2012 Jan;27(1):7-22
references.pmid: 22189245
references.citation: Radiology. 2005 Jun;235(3):1050-4
references.pmid: 15833986
references.citation: Acad Radiol. 2008 Dec;15(12):1494-504
references.pmid: 19000866
references.citation: Curr Opin Pulm Med. 2013 Sep;19(5):422-9
references.pmid: 23907454
references.citation: Semin Respir Crit Care Med. 2014 Feb;35(1):41-9
references.pmid: 24481758
references.citation: Eur Radiol. 2007 Jun;17(6):1510-7
references.pmid: 17151859
references.citation: N Engl J Med. 2004 May 27;350(22):2257-64
references.pmid: 15163775
references.citation: Ann Thorac Surg. 2003 Nov;76(5):1457-62; discussion 1462-4
references.pmid: 14602267
references.citation: Eur J Radiol. 2012 Dec;81(12):3711-8
references.pmid: 21420812
references.citation: J Nucl Med. 1997 Jun;38(6):980-3
references.pmid: 9189155
references.citation: AJR Am J Roentgenol. 2004 Jan;182(1):67-72
references.pmid: 14684514
references.citation: Rofo. 2008 Oct;180(10):879-83
references.pmid: 19238637
references.citation: Chest. 1995 Jan;107(1 Suppl):10S-17S
references.pmid: 7813322
references.citation: AJR Am J Roentgenol. 2008 May;190(5):1169-73
references.pmid: 18430827
references.citation: Am J Respir Crit Care Med. 2011 Jun 15;183(12):1605-13
references.pmid: 21330453
references.citation: Invest Radiol. 2012 Jan;47(1):85-91
references.pmid: 22107805
references.citation: Clin Radiol. 2009 Apr;64(4):414-9
references.pmid: 19264187
references.citation: AJR Am J Roentgenol. 2012 Nov;199(5 Suppl):S40-53
references.pmid: 23097167
references.citation: Semin Respir Crit Care Med. 2012 Apr;33(2):199-204
references.pmid: 22648493
references.citation: Radiology. 2007 Nov;245(2):315-29
references.pmid: 17848685
references.citation: J Thorac Cardiovasc Surg. 1993 Jul;106(1):116-26; discussion 126-7
references.pmid: 8320990
references.citation: Radiographics. 2004 Sep-Oct;24(5):1219-38
references.pmid: 15371604
references.citation: Br J Radiol. 2010 Aug;83(992):707-18
references.pmid: 20551257
references.citation: AJR Am J Roentgenol. 2013 Mar;200(3):522-8
references.pmid: 23436840