Dual-energy CT (DECT) lung perfusion in pulmonary hypertension: concordance rate with V/Q scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH).

Objectives: To evaluate the concordance between DECT perfusion and ventilation/perfusion (V/Q) scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH).Methods: Eighty patients underwent V/Q scintigraphy and DECT perfusion on a 2nd- and 3rd-generation dual-source CT system. T...

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Publicado en:European Radiology Vol. 28; no. 12; pp. 5100 - 5111
Autores principales: Masy, Matthieu, Giordano, Jessica, Petyt, Grégory, Hossein-Foucher, Claude, Duhamel, Alain, Kyheng, Maeva, De Groote, Pascal, Fertin, Marie, Lamblin, Nicolas, Bervar, Jean-François, Remy, Jacques, Remy-Jardin, Martine
Formato: Journal Article
Publicado: Springer Nature Dec2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2018
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-018-5467-2
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        atl: Dual-energy CT (DECT) lung perfusion in pulmonary hypertension: concordance rate with V/Q scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH).
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        au:
          Masy, Matthieu
          Giordano, Jessica
          Petyt, Grégory
          Hossein-Foucher, Claude
          Duhamel, Alain
          Kyheng, Maeva
          De Groote, Pascal
          Fertin, Marie
          Lamblin, Nicolas
          Bervar, Jean-François
          Remy, Jacques
          Remy-Jardin, Martine
        affil: Department of Thoracic Imaging, Calmette Hospital (EA 2694); CHRU et Université de Lille 2 Nord de France, F-59000, Lille, France
      sug:
        subj:
          Pulmonary Embolism
          Tomography, X-Ray Computed Methods
          Hypertension, Pulmonary
          Female
          Adult
          Aged, 80 and Over
          Middle Age
          Male
          Sensitivity and Specificity
          Lung
          Reproducibility of Results
          Perfusion Imaging Methods
          Young Adult
          Ventilation-Perfusion Ratio
          Aged
          Chronic Disease
          Clinical Assessment Tools
          Adult: 19-44 years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
          Male
      ab: Objectives: To evaluate the concordance between DECT perfusion and ventilation/perfusion (V/Q) scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH).Methods: Eighty patients underwent V/Q scintigraphy and DECT perfusion on a 2nd- and 3rd-generation dual-source CT system. The imaging criteria for diagnosing CTEPH relied on at least one segmental triangular perfusion defect on DECT perfusion studies and V/Q mismatch on scintigraphy examinations.Results: Based on multidisciplinary expert decisions that did not include DECT perfusion, 36 patients were diagnosed with CTEPH and 44 patients with other aetiologies of PH. On DECT perfusion studies, there were 35 true positives, 6 false positives and 1 false negative (sensitivity 0.97, specificity 0.86, PPV 0.85, NPV 0.97). On V/Q scans, there were 35 true positives and 1 false negative (sensitivity 0.97, specificity 1, PPV 1, NPV 0.98). There was excellent agreement between CT perfusion and scintigraphy in diagnosing CTEPH (kappa value 0.80). Combined information from DECT perfusion and CT angiographic images enabled correct reclassification of the 6 false positives and the unique false negative case of DECT perfusion.Conclusion: There is excellent agreement between DECT perfusion and V/Q scintigraphy in diagnosing CTEPH. The diagnostic accuracy of DECT perfusion is reinforced by the morpho-functional analysis of data sets.Key Points: • Chronic thromboembolic pulmonary hypertension (CTEPH) is potentially curable by surgery. • The triage of patients with pulmonary hypertension currently relies on scintigraphy. • Dual-energy CT (DECT) can provide standard diagnostic information and lung perfusion from a single acquisition. • There is excellent agreement between DECT perfusion and scintigraphy in separating CTEPH and non-CTEPH patients.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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