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 2018; 24: 139-145
DOI: 10.5152/dir.2018.17311


PURPOSE: We aimed 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 computed tomography (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 symmetric type (131 patients, 78.0%), gradual type (25 patients, 14.9%), and asymmetric type (12 patients, 7.1%).


RESULTS: Acute PTE was diagnosed in all 12 patients with asymmetric type (100%), 19 of the 25 patients with gradual type (76%) and 24 of the 131 patients with symmetric 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 asymmetric types were regarded as positive for PTE, the specificity, positive predictive value, negative predictive value, 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.


You may cite this article as: Okada M, Nomura T, Nakashima Y, Kunihiro Y, Kido S. Histogram-pattern analysis of the lung perfused blood volume for assessment of pulmonary thromboembolism. Diagn Interv Radiol 2018; 24:139–145.

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