基于能谱CT的碘基图与CT肺动脉造影对肺动脉栓塞的诊断效能对比研究OA

Objective To compare the diagnostic value of iodine-based maps based on spectral CT and CT pulmonary an-giography(CTPA)in the diagnosis of pulmonary segmental and subsegmental pulmonary embolism,so as to explore the clin-ical application significance of combined diagnostic strategies.Methods A retrospective study was conducted on 180 clini-cally diagnosed patients with pulmonary embolism who were admitted between September 2023 and July 2025.All patients underwent spectral CT scanning using a GE Revolution 256-slice spectral CT scanner,and iodine-based maps were generated through the GE Revolution 256-slice CT post-processing software(AW4.6).Image analysis included embolus location distri-bution,morphological types,and functional indicators.Statistical analysis was performed using R 4.4.1,with data organized using the tidyverse package,t-tests and chi-square tests conducted using the stats package,and ROC curve analysis was per-formed using pROC package.In addition,the area under the curve(AUC)was calculated,and the optimal diagnostic cutoff value was determined.Results The overall detection rates of CTPA,iodine-based morphology,and functional imaging were 93.9%,98.3%,and 61.1%,respectively.The detection rates of subsegmental emboli were 83.9%,95.2%,and 80.6%,respectively.The perfusion defect rate for occlusive emboli reached 100%.The iodine-based value in the embolic region(8.96±8.38)was significantly lower than that in the control region(19.29±8.31).The AUC for diagnosing perfusion de-fects using relative iodine-based values was 0.97,and the AUC for identifying occlusive emboli using the difference in iodine-based values was 0.86.Conclusion CTPA and iodine-based imaging have clear complementary value in the diagnosis of pulmonary embolism.A combined diagnostic strategy can not only significantly increase the detection rate of emboli,but also achieve functional assessment through quantitative analysis of iodine values,which can establish a complete diagnostic system from anatomical localization to functional evaluation,so as to provide reliable imaging evidence for the precise diagnosis and treatment of pulmonary embolism.