Journal article
Qualitative and quantitative DECT pulmonary angiography in COVID-19 pneumonia and pulmonary embolism
Clinical radiology, Vol.76(5), pp.392.e1-392.e9
05/01/2021
DOI: 10.1016/j.crad.2021.02.009
PMCID: PMC7906503
PMID: 33714541
Abstract
AIM: To assess differences in qualitative and quantitative parameters of pulmonary perfusion from dual-energy computed tomography (CT) pulmonary angiography (DECT-PA) in patients with COVID-19 pneumonia with and without pulmonary embolism (PE).
MATERIALS AND METHODS: This retrospective institutional review board-approved study included 74 patients (mean age 61 +/- 18 years, male:female 34:40) with COVID-19 pneumonia in two countries (one with 68 patients, and the other with six patients) who underwent DECT-PA on either dual-source (DS) or single-source (SS) multidetector CT machines. Images from DS-DECT-PA were processed to obtain virtual mono-energetic 40 keV (Mono40), material decomposition iodine (MDI) images and quantitative perfusion statistics (QPS). Two thoracic radiologists determined CT severity scores based on type and extent of pulmonary opacities, assessed presence of PE, and pulmonary parenchymal perfusion on MDI images. The QPS were calculated from the CT Lung Isolation prototype (Siemens). The correlated clinical outcomes included duration of hospital stay, intubation, SpO(2) and death. The significance of association was determined by receiver operating characteristics and analysis of variance.
RESULTS: One-fifth (20.2%, 15/74 patients) had pulmonary arterial filling defects; most filling defects were occlusive (28/44) located in the segmental and sub-segmental arteries. The parenchymal opacities were more extensive and denser (CT severity score 24 +/- 4) in patients with arterial filling defects than without filling defects (20 +/- 8; p=0.028). Ground-glass opacities demonstrated increased iodine distribution; mixed and consolidative opacities had reduced iodine on DS-DECT-PA but increased or heterogeneous iodine content on SS-DECT-PA. QPS were significantly lower in patients with low SpO(2) (p=0.003), intubation (p=0.006), and pulmonary arterial filling defects (p=0.007).
CONCLUSION: DECT-PA QPS correlated with clinical outcomes in COVID-19 patients. (C) 2021 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Details
- Title: Subtitle
- Qualitative and quantitative DECT pulmonary angiography in COVID-19 pneumonia and pulmonary embolism
- Creators
- C. D. Arru - Massachusetts General HospitalS. R. Digumarthy - Massachusetts General HospitalJ. Hansen - Aarhus University HospitalM. D. Lyhne - Aarhus University HospitalR. Singh - Massachusetts General HospitalR. Rosovsky - Massachusetts General HospitalJ. E. Nielsen-Kudsk - Aarhus UniversityC. Kabrhel - Massachusetts General HospitalL. Saba - Azienda Ospedaliero-Universitaria CagliariM. K. Kalra - Massachusetts General Hospital
- Resource Type
- Journal article
- Publication Details
- Clinical radiology, Vol.76(5), pp.392.e1-392.e9
- Publisher
- Elsevier
- DOI
- 10.1016/j.crad.2021.02.009
- PMID
- 33714541
- PMCID
- PMC7906503
- ISSN
- 0009-9260
- eISSN
- 1365-229X
- Number of pages
- 9
- Language
- English
- Date published
- 05/01/2021
- Academic Unit
- Radiology
- Record Identifier
- 9984697636202771
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