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.