title: Impact of CT perfusion imaging on the assessment of peripheral chronic pulmonary thromboembolism: clinical experience in 62 patients.
abstract: OBJECTIVE
  To evaluate the impact of CT perfusion imaging on the detection of peripheral chronic pulmonary embolisms (CPE).
  
  
  METHODS
  62 patients underwent a dual-energy chest CT angiographic examination with (a) reconstruction of diagnostic and perfusion images; (b) enabling depiction of vascular features of peripheral CPE on diagnostic images and perfusion defects (20 segments/patient; total: 1240 segments examined). The interpretation of diagnostic images was of two types: (a) standard (i.e., based on cross-sectional images alone) or (b) detailed (i.e., based on cross-sectional images and MIPs).
  
  
  RESULTS
  The segment-based analysis showed (a) 1179 segments analyzable on both imaging modalities and 61 segments rated as nonanalyzable on perfusion images; (b) the percentage of diseased segments was increased by 7.2 % when perfusion imaging was compared to the detailed reading of diagnostic images, and by 26.6 % when compared to the standard reading of images. At a patient level, the extent of peripheral CPE was higher on perfusion imaging, with a greater impact when compared to the standard reading of diagnostic images (number of patients with a greater number of diseased segments: n = 45; 72.6 % of the study population).
  
  
  CONCLUSIONS
  Perfusion imaging allows recognition of a greater extent of peripheral CPE compared to diagnostic imaging.
  
  
  CONCLUSIONS
  • Dual-energy computed tomography generates standard diagnostic imaging and lung perfusion analysis. • Depiction of CPE on central arteries relies on standard diagnostic imaging. • Detection of peripheral CPE is improved by perfusion imaging.
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University of Lille, CHU Lille, EA 2694, F-59000, Lille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Le Faivre
authors.affiliation: Department of Biostatistics, University of Lille, CHU Lille, EA 2694, F-59000, Lille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University of Lille, CHU Lille, EA 2694, F-59000, Lille, France.
authors.forename: Suonita
authors.initials: S
authors.lastname: Khung
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University of Lille, CHU Lille, EA 2694, F-59000, Lille, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Faivre
authors.affiliation: Department of Cardiology, Cardiology Hospital, University of Lille, CHU Lille, F-59000, Lille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University of Lille, CHU Lille, EA 2694, F-59000, Lille, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Remy
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University of Lille, CHU Lille, EA 2694, F-59000, Lille, France. martine.remy@chru-lille.fr.
authors.forename: Martine
authors.initials: M
authors.lastname: Remy-Jardin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D000072226:Computed Tomography Angiography / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: CT angiography; Chronic thromboembolism; Dual-energy CT; Dual-energy lung perfusion imaging; Pulmonary hypertension