Development of a lung perfusion automated quantitative model based on dual-energy CT pulmonary angiography in patients with chronic pulmonary thromboembolism

作者：Linfeng Xi, Jianping Wang, Anqi Liu, Yifei Ni, Jie Du, Qiang Huang, Yishan Li, Jing Wen, Hongyi Wang, Shuai Zhang, Yunxia Zhang, Zhu Zhang, Dingyi Wang, Wanmu Xie, Qian Gao, Yong Cheng, Zhenguo Zhai, Min Liu · 发表于：Insights into Imaging · 年份：2025 · DOI：10.1186/s13244-025-02067-6 · 被引用次数：3 · 研究领域：Pulmonary Hypertension Research and Treatments、Venous Thromboembolism Diagnosis and Management、Cardiac Imaging and Diagnostics

OBJECTIVE: To develop PerAIDE, an AI-driven system for automated analysis of pulmonary perfusion blood volume (PBV) using dual-energy computed tomography pulmonary angiography (DE-CTPA) in patients with chronic pulmonary thromboembolism (CPE). MATERIALS AND METHODS: In this prospective observational study, 32 patients with chronic thromboembolic pulmonary disease (CTEPD) and 151 patients with chronic thromboembolic pulmonary hypertension (CTEPH) were enrolled between January 2022 and July 2024. PerAIDE was developed to automatically quantify three distinct perfusion patterns-normal, reduced, and defective-on DE-CTPA images. Two radiologists independently assessed PBV scores. Follow-up imaging was conducted 3 months after balloon pulmonary angioplasty (BPA). RESULTS: PerAIDE demonstrated high agreement with the radiologists (intraclass correlation coefficient = 0.778) and reduced analysis time significantly (31 ± 3 s vs. 15 ± 4 min, p < 0.001). CTEPH patients had greater perfusion defects than CTEPD (0.35 vs. 0.29, p < 0.001), while reduced perfusion was more prevalent in CTEPD (0.36 vs. 0.30, p < 0.001). Perfusion defects correlated positively with pulmonary vascular resistance (ρ = 0.534) and mean pulmonary artery pressure (ρ = 0.482), and negatively with oxygenation index (ρ = -0.441). PerAIDE effectively differentiated CTEPH from CTEPD (AUC = 0.809, 95% CI: 0.745-0.863). At the 3-month post-BPA, a significant reduction in perfusion defects was observed (0.36 vs. 0.33, p < ...