双能量CT肺动脉联合间接下肢静脉造影对静脉栓塞症诊断的临床研究.docVIP

华 中 科 技 大 学 硕 士 学 位 论 文 Abst ract P art one: The clinical a pplicat ion of combine d dual-e ne rgy CT pulmo na ry ang iog raphy and indirect CT venogra phy Obje ctive : To assess the clinial application of co mb ined d ual-energy CT pulmonary angiography (DE-CTPA) and ind irec t CT ve no grap hy （CTV） in the d ia gnosis of ve no us thro mboe mbo lis m (VTE). Methods: Forty nine pa tie nts with leg swelling suspected of p ulmo nary e mbo lism (P E) from September 20 11 to March 2012 underwent DE-CTPA co mb ined with C TV. All of them has taken lo wer extremity ve no us ultrasound (US) in 1 week a head of CT exa mina tio n. DE-CTPA images and CTV ima ges were a na lysed according to the re lated d ia gnostic crite ria, then the arte ria l e nha nce me nt of p ulmo nary trunk was recorded as well as the attenuatio n va lue of the thro mb us. Recorded the numbe r and lo catio n of filling defects in the dual energy perfusio n ima ge (DEPI). Subjective ima ge q ua lity of CTPA and DEP I was rated using a 5-point scale by two experienced expertises. The coherence between them was analysed by Kappa statistics. The cohe re nce of findings between CTV and US in the ability to d iagno se deep ve no us thro mbos is （DVT）was analysed by Pa ired Chi-square test. The radiation dose of the co mb ined scanning protocol was recorded and c a lc ulated. Results: Twe nty nine pa tie nts were ide ntif ied with PE by DE-CTPA, inc lud ing 28 pa tie nts id e ntified by C TPA and one more by DEP I, and 21 patients with both PE and DV T. Both DE-CTPA and DEPI had positive findings for p ulmo nary e mbo lism in 19 patie nts and both had negative findings in 18 patients. 5 华 中 科 技 大 学 硕 士 学 位 论 文 Eighty six filling de fec ts were fo und in DEPI, co mpared with o utco me of CTPA, there was a moderate a gree me nt between asses s me nt of DEPI and DE-CTPA (Kappa value=0.7534 ). Thirty eight patients with DVT were ide ntifie d by US, 11 patie nts were identified ne ga tive by US while 10 were