Where do we stand? Functional imaging in acute and chronic pulmonary embolism with state-of-the-art CT

Meyer, Mathias; Haubenreisser, Holger; Sudarski, Sonja; Doesch, Christina; Ong, Melissa; Borggrefe, Martin; Schoenberg, Stefan O.; Henzler, Thomas

doi:10.1016/j.ejrad.2015.09.015

Cited by 11 publications

(5 citation statements)

References 64 publications

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“…By simultaneous acquisition of two CTPA datasets at different tube energies, the energy dependent X-ray attenuation characteristics of certain elements like calcium and iodine can be utilized for material quantification [12,13]. The use of postprocessing software allows for direct visualization of pulmonary iodine distribution maps, which can be analyzed for perfusion defects, thus improving diagnostic performance of CTPA [14][15][16][17][18]. Moreover, the automatic quantification of pulmonary perfused blood volume (PBV) enables fast and reader-independent evaluation iodine distribution within the lung parenchyma, which correlates with thrombus load, laboratory parameters of PE severity, and admission to an intensive care unit [10,15,17,[19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume

Kosmala

Gruschwitz

Veldhoen

et al. 2020

Int J Cardiovasc Imaging

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To compare intravenous contrast material (CM) injection protocols for dual-energy CT pulmonary angiography (CTPA) in patients with suspected acute pulmonary embolism with regard to image quality and pulmonary perfused blood volume (PBV) values. A total of 198 studies performed with four CM injection protocols varying in CM volume and iodine delivery rates (IDR) were retrospectively included: (A) 60 ml at 5 ml/s (IDR = 1.75gI/s), (B) 50 ml at 5 ml/s (IDR = 1.75gI/s), (C) 50 ml at 4 ml/s (IDR = 1.40gI/s), (D) 40 ml at 3 ml/s (IDR = 1.05gI/s). Image quality and PBV values at different resolution settings were compared. Pulmonary arterial tract attenuation was highest for protocol A (397 ± 110 HU; p vs. B = 0.13; vs. C = 0.02; vs. D < 0.001). CTPA image quality of protocol A was rated superior compared to protocols B and D by reader 1 (p = 0.01; < 0.001), and superior to protocols B, C and D by reader 2 (p < 0.001; 0.02; < 0.001). Otherwise, there were no significant differences in CTPA quality ratings. Subjective iodine map ratings did not vary significantly between protocols A, B, and C. Both readers rated protocol D inferior to all other protocols (p < 0.05). PBV values did not vary significantly between protocols A and B at resolution settings of 1, 4 and 10 (p = 0.10; 0.10; 0.09), while otherwise PBV values displayed a decreasing trend from protocol A to D (p < 0.05). Higher CM volume and IDR are associated with superior CTPA and iodine map quality and higher absolute PBV values.

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Section: Introductionmentioning

confidence: 99%

Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume

Kosmala

Gruschwitz

Veldhoen

et al. 2020

Int J Cardiovasc Imaging

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“…Die Lungenarterienembolie (LAE) ist die dritthäufigste der akuten kardiovaskulären Erkrankungen und bedarf wegen ihrer akuten Lebensbedrohlichkeit einer zuverlässigen Diagnostik und einer schnellen risikoadaptierten Therapie 21 22 . Die LAE resultiert typischerweise aus einer tiefen Venenthrombose (TVT) der unteren Extremitäten 23 .…”

Section: Pulmonalarterienembolieunclassified

Typische Probleme und Fehler im radiologischen Nachtdienst

Storjohann¹,

Pusch²,

Kessler³

et al. 2023

Radiopraxis

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Außerhalb der Regelarbeitszeit wird der Präsenzdienst in den meisten Krankenhäusern von Weiterbildungsassistenten geleistet. Sie sind gut beraten, einerseits die wichtigsten Krankheitsbilder zu kennen, die in dieser Übersichtsarbeit dargestellt werden, und andererseits die Fälle, die sie nicht lösen können, an ihren Hintergrund weiterzuleiten.

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“…However, an iodine map must be interpreted with caution because iodine maps selectively demonstrate iodinated contrast material within the lung parenchyma, not true perfusion [32]. In addition, PE does not always cause perfusion defects in an iodine map [20,25,34,79]. Although the rate of perfusion defects on PBV for occlusive PE is relatively high (82-95%), the rate of perfusion of non-occlusive PE defects may be as low as 6-9% [20,25,34], and other lung diseases can also cause perfusion defects [80].…”

Section: Diagnostic Pitfalls Of Dectmentioning

confidence: 99%

“…In addition, PE does not always cause perfusion defects in an iodine map [20,25,34,79]. Although the rate of perfusion defects on PBV for occlusive PE is relatively high (82-95%), the rate of perfusion of non-occlusive PE defects may be as low as 6-9% [20,25,34], and other lung diseases can also cause perfusion defects [80].…”

Section: Diagnostic Pitfalls Of Dectmentioning

confidence: 99%

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Dual-Energy CT for Pulmonary Embolism: Current and Evolving Clinical Applications

et al. 2021

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Pulmonary embolism (PE) is a potentially fatal disease if the diagnosis or treatment is delayed. Currently, multidetector computed tomography (MDCT) is considered the standard imaging method for diagnosing PE. Dual-energy CT (DECT) has the advantages of MDCT and can provide functional information for patients with PE. The aim of this review is to present the potential clinical applications of DECT in PE, focusing on the diagnosis and risk stratification of PE.

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Where do we stand? Functional imaging in acute and chronic pulmonary embolism with state-of-the-art CT

Cited by 11 publications

References 64 publications

Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume

Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume

Typische Probleme und Fehler im radiologischen Nachtdienst

Dual-Energy CT for Pulmonary Embolism: Current and Evolving Clinical Applications

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