E-ISSN 1305-3612
Chest Imaging - Original Article
Histogram-pattern analysis of the lung perfused blood volume for assessment of pulmonary thromboembolism
1 Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan  
2 Department of Radiology, Yamaguchi Grand Hospital, Hofu, Yamaguchi, Japan  
3 Department of Computer-aided Diagnosis and Biomedical Imaging Research Biomedical Engineering, Applied Medical Engineering Science Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan  
Diagn Interv Radiol ; : -


Purpose: To evaluate the usefulness of histograms of lung perfused blood volume (HLPBV) based on the presence of pulmonary thromboembolism (PTE) and the pulmonary embolic burden.


Methods: A total of 168 patients (55 males, mean age: 62.9 years) underwent contrast-enhanced dual-energy CT (DECT) between January 1 2012 and October 31 2014.  Initial DECT images were three-dimensionally reconstructed, and the HLPBV patterns were divided into three types, including the symmetry-type (131 patients: 78.0%), gradual-type (25 patients: 14.9%) and asymmetry-type (12 patients: 7.1%).


Results:  Acute PTE was diagnosed in all 12 patients with asymmetry-type (100%), 19 of the 25 patients with gradual-type (76.0%) and 24 of the 131 patients with symmetry-type (18.3%).  HLPBV pattern exhibited correlations with the right/left ventricular diameter ratio (r=0.36, p=0.007) and CT obstruction index (r=0.63, p<0.001) in patients with PTEs.  When the gradual- and asymmetry-types were regarded as positive for PTE, the specificity, PPV, NPV and accuracy were 92.9%, 83.8%, 87.6% and 81.0%, respectively.


Conclusion: Histogram-pattern analysis using DECT might be a useful application to diagnose PTE.

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