Evaluation of the diagnostic value of dual energy computer tomography perfusion technique in chronic thromboembolic pulmonary hypertensive disease by comparing it with ventilation / perfusion syntigraphy

The aim of our study is to investigate "Dual Energy Computed Tomography Perfusion Imaging" (DECTP) imaging technique, a new imaging system among the modalities used for the early and definitive diagnosis of Chronic Thromboembolic Pulmonary Hypertension (CTEPH), to evaluate the diagnostic value comparing with V/Q scintigraphy imaging technique based on Computed Tomographic Angiography (CTA) evaluation. 39 CTEPH and pulmonary hypertension (PH) patients, who were guided by clinical and ancillary evaluations and who were definitively diagnosed by CTA imaging, were included in the study together with DECTP and V/Q scintigraphy examination images performed during diagnosis. Patients who had chronic thrombus were identified as CTEPH and the others as non-CTEPH groups. Patients with focal perfusion defects in DECTP were grouped as segmentary and subsegmentary according to their perfusion defects. The patient groups diagnosed with CTEPH by DECTP and V/Q scintigraphy were statistically compared according to the results of the evaluation whether their diagnostic superiority was significant or not. Among the patients diagnosed with DECTP technique, 27 true positive and 2 false positive patients were detected (Sensitivity 1, Specificity 0.83, PPV 0.93, NPV 1), and V/Q Scintigraphic examination revealed 22 true positive, 2 false positives and 4 false negatives. (Sensitivity 0.81, Specificity 0.83, PPV 0.91, NPV 0.66). Conclusion: DECTP imaging is shown to be a modality that increases the sensitivity in the diagnosis of CTEPH patients more than V/Q scintigraphy (p<0.05).