Quantitative Dual-Energy Computed Tomography Predicts Regional Perfusion Heterogeneity in a Model of Acute Lung Injury
| Autor: | Maria Aparecida Miyuki Nakamura, Suhny Abbara, Mauro R. Tucci, Roberta R. De Santis Santiago, Fernando Uliana Kay, Susimeire Gomes, Edson Amaro, Vinicius Torsani, Rollin Roldan, Marcelo A. Beraldo, Marcelo B. P. Amato |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary Circulation
Supine position Swine Radiography Contrast Media Blood volume dual-energy computed tomography Lung injury 030218 nuclear medicine & medical imaging Prone ventilation Radiography Dual-Energy Scanned Projection 03 medical and health sciences 0302 clinical medicine Pulmonary and Thoracic Applications of Dual Energy CT Predictive Value of Tests Animals Medicine Radiology Nuclear Medicine and imaging Lung business.industry Disease Models Animal Prone position medicine.anatomical_structure acute lung injury 030220 oncology & carcinogenesis biomarker Tomography X-Ray Computed business Nuclear medicine Perfusion |
| Zdroj: | Journal of Computer Assisted Tomography |
| ISSN: | 0363-8715 |
| DOI: | 10.1097/rct.0000000000000815 |
| Popis: | Objective The aims of this study were to investigate the ability of contrast-enhanced dual-energy computed tomography (DECT) for assessing regional perfusion in a model of acute lung injury, using dynamic first-pass perfusion CT (DynCT) as the criterion standard and to evaluate if changes in lung perfusion caused by prone ventilation are similarly demonstrated by DECT and DynCT. Methods This was an institutional review board–approved study, compliant with guidelines for humane care of laboratory animals. A ventilator-induced lung injury protocol was applied to 6 landrace pigs. Perfused blood volume (PBV) and pulmonary blood flow (PBF) were respectively quantified by DECT and DynCT, in supine and prone positions. The lungs were segmented in equally sized regions of interest, namely, dorsal, middle, and ventral. Perfused blood volume and PBF values were normalized by lung density. Regional air fraction (AF) was assessed by triple-material decomposition DECT. Per-animal correlation between PBV and PBF was assessed with Pearson R. Regional differences in PBV, PBF, and AF were evaluated with 1-way analysis of variance and post hoc linear trend analysis (α = 5%). Results Mean correlation coefficient between PBV and PBF was 0.70 (range, 0.55–0.98). Higher PBV and PBF values were observed in dorsal versus ventral regions. Dorsal-to-ventral linear trend slopes were −10.24 mL/100 g per zone for PBV (P < 0.001) and −223.0 mL/100 g per minute per zone for PBF (P < 0.001). Prone ventilation also revealed higher PBV and PBF in dorsal versus ventral regions. Dorsal-to-ventral linear trend slopes were −16.16 mL/100 g per zone for PBV (P < 0.001) and −108.2 mL/100 g per minute per zone for PBF (P < 0.001). By contrast, AF was lower in dorsal versus ventral regions in supine position, with dorsal-to-ventral linear trend slope of +5.77%/zone (P < 0.05). Prone ventilation was associated with homogenization of AF distribution among different regions (P = 0.74). Conclusions Dual-energy computed tomography PBV is correlated with DynCT-PBF in a model of acute lung injury, and able to demonstrate regional differences in pulmonary perfusion. Perfusion was higher in the dorsal regions, irrespectively to decubitus, with more homogeneous lung aeration in prone position. |
| Databáze: | OpenAIRE |
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