The non-contrast dual-layer spectral detector CT has high diagnostic value for acute pulmonary embolism
WU Meihong
LI Xiaohu
SHENG Mao
LIU Ying
HOU Weishu
SHU Hongmin
Abstract：Objective To explore the diagnostic value of non-contrast dual-layer spectral detector CT with multiple parameters in acute pulmonary embolism.Methods Fifty-two patients(86 lesions)with acute pulmonary embolism who underwent non-contrast and CT pulmonary angiography(CTPA)using dual-layer spectral detector CT at the Second People's hospital of Hefei(Hefei Hospital Affiliated to Anhui Medical University)from January 2022 to October 2023 were retrospectively analyzed.Taking CTPA as the gold standard,subjective visual evaluation was performed on four sets of images including conventional 120 kVp polyenergetic images(PI),effective atomic number maps(Zeff),Electron density maps(EDM),and EDM-Zeff fusion maps,and the detection rate of pulmonary embolism was calculated for each set of images.A pulmonary embolism group and a control group were set up according to the presence or absence of emboli in the blood vessels.CTPI,CT40 keV,CT70 keV,CT100 keV,ED values and Zeff values were measured and recorded between the two groups,then compare the differences and perform multivariate logistic regression to construct a regression model.ROC curve was applied to evaluate the diagnostic efficiency of each parameter and logistic regression model.Delong test was used to compare the AUCs.Results The detection rates of APE on PI,Zeff,EDM,EDM and Zeff map fusion images were 10.47%,1.16%,54.65%,69.77%,respectively.The subjective scoring Kappa values of the four sets of images were 0.73,0.79,0.81,and 0.84,respectively.Except for Zeff values,CTPI,CT40 keV,CT70 keV,CT100 keV,ED values in pulmonary embolism group were statistically higher than those in control group(P<0.05).Among all the parameters,the logistic regression model has the highest diagnostic efficiency(AUC=0.76),with a threshold of 0.56,sensitivity and specificity in diagnosing APE were 58.1%and 87.2%,respectively.Delong test showed that the AUC of CT40keV was lower than CT70 keV,CT100 keV,logistic groups(P<0.05),and the AUC of CTPI was lower than CT100keV、Logistic groups(P<0.05),then there was no significant difference in the AUC of other parameters(P>0.05).Conclusion The combination of non-contrast images of dual-layer spectral detector CT PI,VMI,EDM have important diagnostic value for acute pulmonary embolism.
Keywords：acute pulmonary embolismvirtual monoenergetic imageelectron densityeffective atomic number
Publication Date：2025-08-20
Online Publishing Date：2025-09-22(First online date of this platform, not the publication date of the document)
Pages：6( 1022-1027 )