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首页> 外文期刊>Academic radiology >Reduced Perfusion in Pulmonary Infiltrates of High-risk Hematologic Patients Is a Possible Discriminator of Pulmonary Angioinvasive Mycosis. A Pilot Volume Perfusion Computed Tomography (VPCT) Study
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Reduced Perfusion in Pulmonary Infiltrates of High-risk Hematologic Patients Is a Possible Discriminator of Pulmonary Angioinvasive Mycosis. A Pilot Volume Perfusion Computed Tomography (VPCT) Study

机译：降低高危血液学患者的肺渗透灌注是肺血管肌病患者的可能判断。 试验卷灌注计算机断层扫描（VPCT）研究

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Rationale and Objectives: The aim of this study was to assess perfusion parameters in atypical pneumonia of heavily immunocompromised hematologic patients suspected of having invasive mycosis using volume perfusion computed tomography and establish their diagnostic role. Materials and Methods: Volume perfusion computed tomographic data from 21 consecutive immunocompromised patients presenting with atypical parenchymal opacity of consolidation were analyzed with respect to the degree of perfusion of their pneumonias. All patients presented with clinical and laboratory signs of infection. Seventeen patients (10 men, seven women; mean age, 57 years; age range, 19-76 years) were found with proven (n = 9), probable (n = 2), or possible (n = 6) angioinvasive mycosis. One patient was diagnosed with bronchoinvasive aspergillosis. Four patients (all men; mean age, 71 years; age range, 67-79 years) were diagnosed with bacterial pneumonia. Volume perfusion computed tomography of the involved pulmonary areas was performed at 80 kV and 60 mAs, with 26 measurement points distributed over 65.9 seconds. Fifty milliliters of contrast material was injected at a rate of 5 mL/s, followed by a 50-mL saline chaser. Entire coverage of the pneumonic parenchymal consolidation was obtained in all patients, with the generation of parametric maps of blood flow (BF) using the maximal slope model and blood volume (BV) using Patlak analysis. The results of perfusion measurements were then analyzed and evaluated for all patients. Results: Patients with proven, probable, or possible angioinvasive pulmonary fungal infection revealed very low levels of perfusion of their parenchymal consolidations, with BFs ranging from 0.01 to 23.86 mL/100 mL tissue/min and BVs ranging from 0.88 to 10.67 mL/100 mL tissue, lower than those of the adjacent thoracic musculature and of bacterial pneumonias. Bacterial pneumonias showed all increased perfusion parameters, with BFs ranging from 30.49 to 41.65 mL/100 mL tissue/min and BVs ranging from 10.07 to 49.90 mL/100 mL tissue. The cutoff BF value for differentiation was 23.89 mL/100 mL tissue/min, and the cutoff BV value was 9.6 mL/100 mL tissue. Conclusions: Patients with angioinvasive pulmonary mycosis showed lower perfusion parameters on volume perfusion computed tomography compared to those experiencing bacterial pneumonia.
机译：理由和目标：本研究的目的是评估使用体积灌注计算断层扫描的患有侵袭性肌菌病的纯度血管菌患者的非典型肺炎的灌注参数，并建立其诊断作用。材料和方法：在肺炎灌注程度上分析了来自21例连续的免疫功能性患者的体积灌注计算的分析，其具有非典型实质透明度的综合性。所有患者均呈现临床和实验室感染症状。 17名患者（10名男性，七名女性;平均年龄，57岁;年龄范围，19-76岁）被证明（n = 9），可能（n = 2），或可能的（n = 6）血管肌肌菌。一名患者被诊断为支气管胰腺炎。四名患者（所有人;平均年龄，71岁;年龄范围，67-79岁）被诊断出患有细菌肺炎。涉及肺部区域的体积灌注计算机断层扫描在80kV和60 mas下进行，26个测量点分布超过65.9秒。以5mL / s的速率注射五十毫升的造影剂，然后用50ml盐水追踪剂注射。在所有患者中获得全面覆盖肺部实质整合，并使用Patlak分析使用最大斜坡模型和血量（BV）的血流（BF）的参数映射。然后分析灌注测量结果并评估所有患者。结果：经过验证，可能或可能的血管血管肺真菌感染患者揭示了其实质整合的灌注水平非常低，BFS从0.01至23.86ml / 100ml组织/ min，BVS范围为0.88至10.67ml / 100ml组织，低于邻近胸肌肉和细菌肺炎的组织。细菌肺炎显示所有增加的灌注参数，BFS从30.49-41.65ml / 100ml组织/ min，BVS范围为10.07至49.90ml / 100ml组织。分化的切断BF值为23.89ml / 100ml组织/分钟，截止BV值为9.6ml / 100ml组织。结论：血管血管肌菌患者患者对体内灌注计算断层扫描的灌注参数较低，与经历细菌肺炎相比。

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