Diagnostic and Interventional Radiology
Chest Imaging - Original Article

Histogram-pattern analysis of the lung perfused blood volume for assessment of pulmonary thromboembolism


Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan


Department of Radiology, Yamaguchi Grand Hospital, Hofu, Yamaguchi, Japan


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
Read: 822 Downloads: 257 Published: 03 September 2019



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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