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Impact of CT perfusion imaging on the assessment of peripheral chronic pulmonary thromboembolism: clinical experience in 62 patients

  • Computed Tomography
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To evaluate the impact of CT perfusion imaging on the detection of peripheral chronic pulmonary embolisms (CPE).

Materials and 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).


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).


Perfusion imaging allows recognition of a greater extent of peripheral CPE compared to diagnostic imaging.

Key Points

• 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.

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The scientific guarantor of this publication is Martine REMY-JARDIN. Two authors of this manuscript declare relationships with Siemens Healthcare: Pr Jacques REMY is consultant for Siemens; Pr Martine REMY-JARDIN has received research support for clinical research activities. The authors state that this work has not received any funding. One of the authors (Pr Alain DUHAMEL) has significant statistical expertise. He is the head of the department of biomedical statistics at our University Centre. Institutional review board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: prospective, observational, performed at one institution.

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Correspondence to Martine Remy-Jardin.

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Le Faivre, J., Duhamel, A., Khung, S. et al. Impact of CT perfusion imaging on the assessment of peripheral chronic pulmonary thromboembolism: clinical experience in 62 patients. Eur Radiol 26, 4011–4020 (2016).

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