Send to

Choose Destination
Eur J Radiol. 2011 Sep;79(3):467-72. doi: 10.1016/j.ejrad.2010.04.018. Epub 2010 May 21.

Dual-energy CT angiography of chronic thromboembolic disease: can it help recognize links between the severity of pulmonary arterial obstruction and perfusion defects?

Author information

Department of Thoracic Imaging, Hospital Calmette, University Centre of Lille (EA 2694), Boulevard Jules Leclercq, 59037 Lille cedex, France.



To evaluate whether dual-energy CT angiography (DE-CTA) could identify links between morphologic and functional abnormalities in chronic pulmonary thromboembolism (CPTE).


Seventeen consecutive patients with CPTE without underlying cardio-respiratory disease were investigated with DE-CTA. Two series of images were generated: (a) transverse diagnostic scans (i.e., contiguous 1-mm thick averaged images from both tubes), and (b) perfusion scans (i.e., images of the iodine content within the microcirculation; 4-mm thick MIPs). Two radiologists evaluated by consensus the presence of: (a) pulmonary vascular features of CPTE and abnormally dilated systemic arteries on diagnostic CT scans, and (b) perfusion defects of embolic type on perfusion scans.


Diagnostic examinations showed a total of 166 pulmonary arteries (166/833; 19.9%) with features of CPTE, more frequent at the level of peripheral than central arteries (8.94 vs 0.82; p<0.0001), including severe stenosis with partial (97/166; 58.4%) or complete (20/166; 12.0%) obstruction, webs and bands (37/166; 22.3%), partial filling defects without stenosis (7/166; 4.2%), focal stenosis (4/166; 2.4%) and abrupt vessel narrowing (1/166; 0.6%). Perfusion examinations showed 39 perfusion defects in 8 patients (median number: 4.9; range: 1-11). The most severe pulmonary arterial features of CPTE were seen with a significantly higher frequency in segments with perfusion defects than in segments with normal perfusion (p<0.0001). Enlarged systemic arteries were observed with a significantly higher frequency ipsilateral to lungs with perfusion defects (9/12; 75%) compared with lungs without perfusion defects (5/22; 22.7%) (p=0.004).


Dual-energy CTA demonstrates links between the severity of pulmonary arterial obstruction and perfusion impairment, influenced by the degree of development of the systemic collateral supply.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center