电阻抗断层扫描检测肺栓塞灌注缺陷的准确性
Accuracy of electrical impedance tomography to detect perfusion defects in pulmonary embolism.
摘要(中文译文)
及时检测肺栓塞（PE）至关重要，特别是在需要快速确认或排除的关键环境中，计算机断层扫描肺血管造影（CTPA）带来了安全挑战。我们评估了电阻抗断层扫描（EIT）-通气灌注（V̇/Q \775）图和一种用于检测PE的新型浪费通气指数的实验和临床准确性。10头仔猪在近端或远端肺动脉闭塞前后接受了EIT-V \775/Q 775;图。EIT灌注图根据动态增强CT（DCE-CT）和全肺CTPA的定量凝块负荷分析进行了验证。为了评估特异性，增加了非闭塞性灌注损伤模型（6头仔猪）。在114种仔猪条件下（66次PE）对浪费通气指数进行了改进，随后在66名急性呼吸衰竭患者（257次检查）和10名慢性血栓栓塞性疾病患者（31次检查）中进行了验证，共288次EIT检查。发现EIT与DCE-CT或CTPA获得的区域灌注估计值之间存在很强的正相关关系。协议显示平均偏差为- 3.04 ± 3.02% 在EIT和DCE-CT之间，以及+ 3.45 ± 2.81% 在EIT和CTPA之间。用AUC进行的通气浪费指数 = 0.989 动物（P < 0.0001;敏感性96%、特异性94%）和AUC = 0.923 患者（P < 0.001;敏感性81%、特异性94%）。溶栓后，该指数持续下降。新的浪费通气指数在检测不同严重程度的肺动脉闭塞方面显示出很高的准确性，将其与其他灌注问题区分开来。它与CTPA、DCE-CT和参考方法的协议支持在常规成像不可行或有风险时，EIT-V 775/Q 775标测作为可靠的诊断辅助。
Abstract
Timely detection of pulmonary embolism (PE) is crucial, particularly in critical settings where rapid confirmation or exclusion is required and computerized tomography pulmonary angiography (CTPA) poses safety challenges. We assessed the experimental and clinical accuracy of electrical impedance tomography (EIT)-ventilation-perfusion (V̇/Q̇) maps and a novel wasted-ventilation index for detecting PE. Ten piglets underwent EIT-V̇/Q̇ mapping before and after proximal or distal pulmonary artery occlusions. EIT-perfusion maps were validated against dynamic contrast-enhanced CT (DCE-CT) and quantitative clot-burden analysis from whole-lung CTPA. To assess specificity, models of non-occlusive perfusion impairment were added (6 piglets). The wasted-ventilation index was refined across 114 piglet conditions (66 PE) and subsequently validated in 66 patients with acute respiratory failure (257 exams) and 10 patients with chronic thromboembolic disease (31 exams), totaling 288 EIT-exams. Strong positive correlations between estimates of regional perfusion obtained by EIT vs. DCE-CT or CTPA were found. Agreement showed mean bias of - 3.04 ± 3.02% between EIT and DCE-CT, and + 3.45 ± 2.81% between EIT and CTPA. The wasted-ventilation index performed with AUC = 0.989 in animals (P < 0.0001; sensitivity 96%, specificity 94%) and AUC = 0.923 in patients (P < 0.001; sensitivity 81%, specificity 94%). The index consistently decreased after thrombolysis. The novel wasted-ventilation index showed high accuracy in detecting pulmonary arterial occlusions of varying severity, distinguishing them from other perfusion problems. Its agreement with CTPA, DCE-CT, and reference methods supports EIT-V̇/Q̇ mapping as a reliable diagnostic aid when conventional imaging is unfeasible or risky.
如何引用
AMA
Eduardo Augusto Pinto Rodrigues, Eder Chaves Pacheco, Maria Aparecida Miyuki Nakamura, Ana Carolina Cardoso Dos Santos, Jade Lara de Melo, Glauco M Plens, et al. Accuracy of electrical impedance tomography to detect perfusion defects in pulmonary embolism.. Critical care (London, England). 2026; doi:10.1186/s13054-026-06073-y.
APA
Eduardo Augusto Pinto Rodrigues, Eder Chaves Pacheco, Maria Aparecida Miyuki Nakamura, Ana Carolina Cardoso Dos Santos, Jade Lara de Melo, Glauco M Plens, et al (2026). Accuracy of electrical impedance tomography to detect perfusion defects in pulmonary embolism.. Critical care (London, England). https://doi.org/10.1186/s13054-026-06073-y
GB/T 7714
Eduardo Augusto Pinto Rodrigues, Eder Chaves Pacheco, Maria Aparecida Miyuki Nakamura, Ana Carolina Cardoso Dos Santos, Jade Lara de Melo, Glauco M Plens, et al. Accuracy of electrical impedance tomography to detect perfusion defects in pulmonary embolism.[J]. Critical care (London, England), 2026 doi:10.1186/s13054-026-06073-y.
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