To explore the value of subtraction iodine mapping CT pulmonary angiography in the diagnosis of acute pulmonary embolism in preoperative patients with ovarian cancer

CHEN Chao; LIU Wei; XU Liming; WANG Yaoshen; QIAN Min

doi:10.19732/j.cnki.2096-6210.2023.02.005

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To explore the value of subtraction iodine mapping CT pulmonary angiography in the diagnosis of acute pulmonary embolism in preoperative patients with ovarian cancer

更新时间：2025-12-15

- To explore the value of subtraction iodine mapping CT pulmonary angiography in the diagnosis of acute pulmonary embolism in preoperative patients with ovarian cancer
- Vol. 32, Issue 2, Pages: 132-137(2023)
- 作者机构：
- 作者简介：
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- DOI：10.19732/j.cnki.2096-6210.2023.02.005
  CLC：
- Published Online：28 April 2023，
  
  Published：28 April 2023
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陈超,刘伟,徐黎明,等. 探究减影CT肺血管造影碘图在卵巢癌患者术前急性肺动脉栓塞诊断中的价值[J]. 肿瘤影像学, 2023, 32(2): 132-137 https://doi.

org/10.19732/j.cnki.2096-6210.2023.02.005
陈超,刘伟,徐黎明,等. 探究减影CT肺血管造影碘图在卵巢癌患者术前急性肺动脉栓塞诊断中的价值[J]. 肿瘤影像学, 2023, 32(2): 132-137 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.02.005.

org/10.19732/j.cnki.2096-6210.2023.02.005 DOI：

摘要

目的：

探讨计算机体层成像肺血管造影（computed tomographic pulmonary angiography，CTPA）图像使用减影软件生成减影CTPA碘图对卵巢癌（ovarian cancer，OC）患者术前急性肺动脉栓塞（acute pulmonary embolism，APE）的诊断价值。

方法：

分析2018年1月2022年6月术前怀疑为APE且在320排CT上行CTPA检查的OC患者影像学资料，并使用SURE Subtraction Lung软件生成减影CTPA碘图，结合临床及影像学数据评估减影CTPA碘图对APE的诊断效能。

结果：

符合纳入标准的302例OC患者中，21例（6.95%）患有APE。共检出栓子70个，于肺动脉主干10个（14.29%），肺叶动脉17个（24.29%），段肺动脉29个（41.43%），亚段及以下肺动脉14个（20.00%）。与诊断标准相比，CTPA检出55个，漏诊15个，误诊50个；减影CTPA碘图检出65个，漏诊5个，误诊22个。根据诊断数据分析，使用CTPA诊断APE的灵敏度为57.14%，特异度为82.56%；减影CTPA碘图诊断APE的灵敏度和特异度分别为85.71%和92.53%。在基于分段分析中，58个（82.86%）栓子在碘图上表现出相应的楔形灌注缺损（perfusion defect，PD）。与正常肺实质相比，与APE相关的PD定量灌注显著降低（0.0380.030 vs 0.1190.035，

＜0.001）。

结论：

减影CTPA碘图可提高肺动脉微小栓子的检出率和术前OC患者APE的诊断准确度，其影像学诊断效能高于普通CTPA。

Abstract

Objectives:

To explore the diagnostic value of iodine maps of computed tomographic pulmonary angiography (CTPA) in acute pulmonary embolism (APE) in preoperative patients with ovarian cancer (OC).

Methods:

The data of OC patients who suspected APE before surgery and underwent CTPA examination on 320-slice CT from January 2018 to June 2022 were analyzed. SURE Subtraction Lung software was used to generate subtraction CTPA iodine map

and the diagnostic efficacy of subtraction CTPA iodine map for APE was evaluated based on clinical and imaging data.

Results:

Among 302 OC patients

21 (6.95%) had APE with 70 emboli of pulmonary arteries

including 10 main pulmonary arteries (14.29%)

17 lobar pulmonary arteries (24.29%)

29 segmental pulmonary arteries (41.43%)

and 14 sub-segmental or lower pulmonary arteries (20.00%). Compared with the standard diagnosis

55 cases were detected by CTPA

15 cases were missed and 50 cases were misdiagnosed

and 65 cases were detected by subtraction CTPA iodine map

5 cases were missed and 22 cases were misdiagnosed. The sensitivity and specificity of CTPA alone in diagnosing APE were 57.14% and 82.56%

respectively. The sensitivity and specificity of subtraction CTPA iodine map in diagnosing APE were 85.71% and 92.53%

respectively. In segmental analysis

58 (82.86%) apes showed corresponding wedge-shaped PD on the iodine maps. Compared with normal lung parenchyma

quantitative perfusion in APE-associated PD was significantly lower (0.0380.030 vs 0.1190.035

＜0.001).

Conclusion:

Subtraction CTPA iodine map can improve the detection rate of pulmonary micro-emboli and the accuracy of preoperative imaging diagnosis of APE in ovarian cancer patients. The imaging diagnostic efficiency of subtraction CTPA iodine map is higher than that of conventional CTPA.

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