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Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism

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Abstract

Objectives

To evaluate the feasibility and findings of combined dual-energy computed tomography (DECT) lung ventilation/perfusion imaging in patients with suspected pulmonary embolism (PE).

Methods

This study was institutional review board-approved and written informed consent was obtained from each patient. Thirty-two subjects (aged 11–61 years) underwent combined xenon-enhanced ventilation and iodine-enhanced perfusion DECT. Ventilation, perfusion and morphological information were visually interpreted. Ventilation/perfusion information was classified as mismatch (differing patterns) or match (concordant patterns). Adverse reactions and radiation doses were recorded for each subject.

Results

Of 32 patients undergoing xenon-enhanced DECT, six patients reported adverse reactions (shortness of breath, n = 2; mild dizziness, n = 3; limb numbness, n = 1). Twenty-eight of 32 patients could be included into the data analysis. PE was detected in 10/28 patients. PE-related ventilation/perfusion mismatch was found in 17 lung lobes in 8/10 patients and matched ventilation/perfusion was detected in 2 patients. Eighteen patients had no PE. In this group, there was no case of a ventilation/perfusion mismatch. Matched ventilation/perfusion impairment was seen in one patient. The overall radiation dose from two DECT acquisitions was 4.8 ± 1.4 mSv (range 2.7-7.5 mSv).

Conclusions

DECT lung ventilation/perfusion imaging is feasible and can visualise ventilation/perfusion match or mismatch in patients with suspected PE.

Key Points

• Combined dual-energy CT lung ventilation/perfusion imaging is feasible.

• Combined dual-energy CT ventilation/perfusion imaging provides lung morphological and functional information.

• Dual-energy CT can demonstrate ventilation/perfusion mismatch in patients with pulmonary embolism.

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Acknowledgements

U.J.S. is a consultant for and receives research support from Bayer, Bracco, GE Healthcare, Medrad and Siemens. The other authors have no conflict of interest to declare.

This work was partially supported by the grant for the Peak of Six Major Talents program of Jiangsu Province of China (No. WSW-122 for L.J.Z.), the Medical Major Talents program of Jiangsu Province of China (RC2011129) and Program for New Century Excellent Talents in University (NCET-12-0260).

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Authors and Affiliations

  1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China

    Long Jiang Zhang, Chang Sheng Zhou, Hui Xue Sheng, Yan E. Zhao, Zong Jun Zhang & Guang Ming Lu

  2. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA

    U. Joseph Schoepf, Aleksander W. Krazinski, Justin R. Silverman & Felix G. Meinel

  3. Medical Imaging Institute of Tianjin, Tianjin, 300192, China

    Sheng Yong Wu

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  1. Long Jiang Zhang
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  2. Chang Sheng Zhou
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  3. U. Joseph Schoepf
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  4. Hui Xue Sheng
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  5. Sheng Yong Wu
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  6. Aleksander W. Krazinski
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  7. Justin R. Silverman
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  8. Felix G. Meinel
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  9. Yan E. Zhao
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  10. Zong Jun Zhang
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  11. Guang Ming Lu
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Corresponding author

Correspondence to Guang Ming Lu.

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Zhang, L.J., Zhou, C.S., Schoepf, U.J. et al. Dual-energy CT lung ventilation/perfusion imaging for diagnosing pulmonary embolism. Eur Radiol 23, 2666–2675 (2013). https://doi.org/10.1007/s00330-013-2907-x

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  • DOI: https://doi.org/10.1007/s00330-013-2907-x

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