Role of lung perfusion analysis with dual energy CT in patients with suspected pulmonary embolism: Perfusion defects are correlated with pulmonary ct angiogram and clinical parameters

Abstract

Introduction: Pulmonary embolism is one amongst the most common causes for cardiovascular death, but this potential fatal condition is treatable if diagnosed on time. Despite various diagnostic modalities and introduction of various new tests diagnosing pulmonary thromboembolism still remains a challenge. Pulmonary Thromboembolism occurs in wide variety of settings. Pulmonary embolism refers to embolic occlusion of pulmonary arterial system. Materials and Methods: This was hospital based prospective study done over a period of July 2015th September 2017 .Clinically suspected patients with pulmonary emboli underwent DECT pulmonary angiography after taking informed consent. Based on inclusion and exclusion criteria patients were selected. DE CTPA finding were reported by separate radiologist, pulmonary perfusion iodine mapping is then evaluated, perfusion defects caused by pulmonary emboli is identified .this is correlated with CTPA findings and clinical parameters if present. Results: Total of 51 patients were included in our study .Youngest patients in our study was 22 year old and eldest was 82 year old. In our study total of 33 were male and 18 female with suspected PE .Out of these people 11.8% were below 30, 33.3% were between 31-50 years, 37.3% were between 51 to 70 years, 17.6% were above 70. Sensitivity and specificity of DECT BFI with reference to CTPA in detecting acute pulmonary embolism was 91.3% and 95.4% respectively Out of 6 cases of chronic emboli only one case showed perfusion defect in DECT BFI suggesting resolution of thrombus /non ochronic emboli. 2 cases of the normal given by CTPA showed perfusion defect in BFI could possibly indicate Sub segmental PE Conclusion: DECT provides both anatomical and perfusion status of the both the lungs .By doing so it has More capacity to improve the accuracy in diagnosis of pulmonary embolism. BFI and CTPA obtained during a single contrast enhanced chest CT scan in dual energy mode with no extra radiation has potential to improve the detection of acute emboli and also the follow up, effectiveness of the treatment and effects of chronic embolism.