宝石能谱CT成像联合MRI在肺动脉栓塞病情评估中的应用价值及其诊断效能OA
Application value and diagnostic efficacy of gemstone spectral CT imaging combined with MRI in the evaluation of pulmonary artery embolism
目的 分析宝石能谱计算机断层扫描(CT)成像联合磁共振成像(MRI)在肺动脉栓塞(PAE)病情评估中的应用价值及其诊断效能.方法 选取中国人民解放军陆军第八十三集团军医院2021年9月至2024年6月收治的87例疑似PAE患者作为研究对象,均接受宝石能谱CT成像及MRI检查,分析宝石能谱CT成像及MRI技术对PAE的诊断效能,比较不同病情程度患者的宝石能谱CT成像碘基值及MRI参数(峰值时间、肺动脉干血流峰值、肺动脉干血流平均速度)水平,并分析其相关性.结果 以CT肺动脉造影为诊断金标准,结果显示阳性67例,阴性20例,宝石能谱CT成像、MRI单独及联合诊断对PAE诊断结果显示阳性63例、59例、71例,与金标准诊断结果一致性Kappa值分别为0.636、0.488、0.791.宝石能谱CT成像及MRI联合诊断PAE的灵敏度、准确度高于单独诊断,漏诊率低于单独诊断(P<0.05);不同病情程度患者MRI峰值时间比较,高危PAE>中危PAE>低危PAE,MRI肺动脉干血流峰值、肺动脉干血流平均速度及碘基值水平比较,高危PAE<中危PAE<低危PAE(P<0.05);MRI峰值时间与患者病情程度呈正相关,肺动脉干血流峰值、肺动脉干血流平均速度及碘基值均与患者病情程度呈负相关(P<0.05).结论 宝石能谱CT成像与MRI联合可提高PAE的诊断价值,同时宝石能谱CT碘基值及MRI相关血流参数与PAE患者病情程度相关,为临床诊断及评估病情提供全面且精准的参考.
[Objective]To analyze the application value and diagnostic efficacy of gemstone spectral computed tomography(CT)imaging combined with magnetic resonance imaging(MRI)in the evaluation of pulmonary artery embolism(PAE).[Methods]A total of 87 patients with suspected PAE admitted to the 83rd Army Group Military Hospital from September 2021 to June 2024 were selected as the research subjects,all of whom underwent gemstone energy spectrum CT imaging and MRI examination.The diagnostic efficacy of gemstone energy spectrum CT imaging and MRI technology for PAE was analyzed,the iodine-based values of gemstone energy spectrum CT imaging and MRI parameters(peak time,peak flow velocity of pulmonary artery trunk,average velocity of pulmonary artery trunk flow)in patients with different disease severity levels were compared,and their correlation was analyzed.[Results]Using CT pulmonary angiography as the gold standard for diagnosis,the results showed that there were 67 positive cases and 20 negative cases.The diagnostic results of gemstone energy spectrum CT imaging,MRI alone,and combined examination for PAE showed 64 positive cases,59 positive cases,and 71 positive cases,respectively.The Kappa values for consistency with the gold standard diagnostic results were 0.636,0.488,and 0.791,respectively.The sensitivity and accuracy of gemstone CT imaging combined with MRI in the diagnosis of PAE were 98.51%and 93.10%,respectively,which were higher than those of single diagnosis;the missed diagnosis rate was 1.49%,which was lower than that of single diagnosis(P<0.05).The peak time of MRI in patients with different disease severity was compared,with high-risk PAE>moderate-risk PAE>low-risk PAE.The peak flow velocity,mean flow velocity,and iodine-based value levels of the pulmonary artery trunk were compared,high-risk PAE<moderate-risk PAE<low-risk PAE(P<0.05).The peak time of MRI was positively correlated with the severity of the patient's condition,while the peak flow velocity of the pulmonary artery trunk,the average velocity of the pulmonary artery trunk flow,and the iodine-based value were negatively correlated with the severity of the patient's condition(P<0.05).[Conclusion]The combination of gemstone spectral CT imaging and MRI can improve the diagnostic value of PAE.At the same time,the iodine-based value of gemstone spectral CT and the relevant blood flow parameters of MRI are correlated with the severity of PAE patients,providing comprehensive and accurate reference for clinical diagnosis and evaluation of the condition.
田慧花;田方;田静文
中国人民解放军陆军第八十三集团军医院 医学影像科,河南 新乡 453000中国人民解放军陆军第八十三集团军医院 医学影像科,河南 新乡 453000中国人民解放军陆军第八十三集团军医院 医学影像科,河南 新乡 453000
医药卫生
宝石能谱计算机断层扫描成像磁共振成像肺动脉栓塞病情程度诊断
gemstone energy spectrum CT imagingMRIpulmonary artery embolismseverity of the conditiondiagnosis
《中国医学工程》 2026 (3)
55-59,5
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