Abstract
Objectives: Analysing the iodine map distribution in patients with pulmonary embolism diagnosis by Dual Energy Computed Tomography. Materials and methods: Twenty-four images of pulmonary angiotomography by dual energy computed tomography were used to determinate the presence of pulmonary thrombi and identify the perfusion defects (PDs) in the Iodine Maps. Moreover, the iodine density (mg/ml) were measured in normal lung parenchyma and lung parenchyma with PDs areas. The documentary analysis was used thought the data collection sheet and the Likert scale questionnaire. The statistic software SPSS v.25 was used. Results: Thirty-four thrombi were found (21 occlusive and 13 partials occlusive) at monochromatic images. Forty-one perfusion defects (PD) were found at Iodine Maps, these have multiple origins: pulmonary thrombi (69.23%), artifacts (17.95%) and other alterations (12.82%). Furthermore, two new thrombi (5.56%) were identified, both were occlusive and segmental level. Mean Iodine density showed statistically significant differences among normal lung parenchyma (1.65 ± 0.66 mg/ml; [0.77-2.79 mg/ ml]) and parenchyma with PD areas (0.51 ± 0.26 mg/ml; [0.12-1.02 mg/ml])(p=0.000). Mean iodine density also had statistically significant differences between parenchyma with occlusive PD and partial occlusive PD (p=0.000). Iodine Map diagnostic quality was excellent (54.17%), good (33.33%), moderate (12.50%). Conclusion: The Iodine distribution Map offers a benefit greater than 5% in the diagnosis of pulmonary embolism by Dual-Energy Computed Tomography.
Highlights
IntroductionRadiological studies are of great importance in diagnosis, Dual Energy Computed Tomography (DECT) is an alternative as a diagnostic method in pulmonary thromboembolism
The main evaluation of pulmonary embolism (PE) is clinical
The main objective of this study was to determine the diagnostic advantage of using the Iodine Map in the diagnosis of pulmonary embolism, as well as to identify the main characteristics of pulmonary thrombi on monochromatic images, to analyse the perfusion defects evidenced on the Iodine Map and to determine the density of normal lung parenchyma and with perfusion defects generated by occlusive and partially occlusive thrombi
Summary
Radiological studies are of great importance in diagnosis, Dual Energy Computed Tomography (DECT) is an alternative as a diagnostic method in pulmonary thromboembolism. Pulmonary embolism or pulmonary thromboembolism (PE) is one of the most common pathologies in hospitals, considered the third most frequent heart disease after acute myocardial infarction and cerebrovascular accident (CVA). Imaging tests have become fundamental and are of great importance in the diagnosis of PE, from conventional chest radiography to more complex studies according to technological advances, such as angiotomography, considered the specific diagnostic test. Dual-energy computed tomography (DECT), uses different energy spectral to differentiate materials and characterize tissues. It is based on the attenuation of different tissues at two different energy levels (80 kVp - 140 kVp) because tissues attenuate differently depending on the composition of their elements. General Electric Healthcare has GSI (Gemstone Spectral Imaging) technology with a single xray tube and one detector system, where the source performs a rapid change of energy (80140 kVp) in the acquisition, based on the ultrafast kV switching and with a cycle time of 0.25 milliseconds. (Chandra & Langan, 2010)
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