Lung ischaemia-reperfusion injury in a canine model: dual-energy CT findings with pathophysiological correlation

To evaluate dual-energy CT (DECT) findings of pulmonary ischaemic-reperfusion injury (PIRI) and its pathophysiological correlation in the canine model. A PIRI model was established in 11 canines, utilizing closed pectoral balloon occlusion. Two control canines were also included. For the PIRI model, the left pulmonary artery was occluded with a balloon, which was deflated and removed after 2 h. DECT was performed before, during occlusion and at 2, 3 and 4 h thereafter and was utilized to construct pulmonary perfusion maps. Immediately after the CT scan at the fourth hour post reperfusion, the canines were sacrificed, and lung specimens were harvested for pathological analysis. CT findings, pulmonary artery pressure and blood gas results were then analysed. Data at every time point were available for 10 animals (experimental group, n = 8; control group, n = 2). Quantitative measurements from DECT pulmonary perfusion maps found iodine attenuation values of the left lung to be the lowest at 2 h post embolization and the highest at 1 h post reperfusion. In the contralateral lung, perfusion values also peaked at 1 h post reperfusion. Continuous hypoxia and acid-based disorders were observed during PIRI, and comprehensive analysis showed physiological changes to be worst at 3 h post reperfusion. DECT pulmonary perfusion mapping demonstrated pulmonary perfusion of the bilateral lungs to be the greatest at 1 h post reperfusion. These CT findings corresponded with pathophysiological changes. DECT pulmonary perfusion mapping can be used to evaluate lung ischaemia-reperfusion injury.