头颅双能CTA及其虚拟平扫诊断颅内出血的初步探讨  

The assessment of intracranial hemorrhage with virtual non-enhanced imaging with dual-energy CTA

作　　者：龙斌 徐凯[2] 胡春峰[2] 孙小伶[2] 

机构地区：[1]武汉市第一人民医院放射科,湖北武汉460022 [2]江苏省徐州医学院附属医院放射科,江苏徐州221002

出　　处：《中国CT和MRI杂志》2011年第3期20-22,共3页Chinese Journal of CT and MRI

摘　　要：目的对双能量头颅CTA虚拟平扫(VNCT)诊断颅内出血的可行性作初步探讨。方法选择临床怀疑颅内出血患者60例经过DE-CTA扫描及头颅平扫CNCT,将DE-CTA虚拟平扫与常规头颅平扫资料进行比较,评价两者结果的一致性,用kappa检验比较两评价者对图像的评价差异,并以常规平扫为标准计算VNCT诊断颅内出血的灵敏度、特异度、阳性预测值和阴性预测值。选择60例经常规头颅CTA病例作对照组,用独立样本t检验比较两种方法头颅CTA病人接受的辐射剂量。结果 VNCT图像与CNCT对于颅内出血的诊断结果差异无统计学意义(P>0.05),两者的一致性较强(kappa=0.721,P<0.01),VNCT诊断颅内出血的灵敏度、特异度、阳性预测值和阴性预测值分别为95.6%、73.3%、91.5%和84.6%;头颅DE-CTA病人接受的辐射剂量(2.36±0.28)mSv明显低于常规头颅CTA(4.20±0.53)mSv,差异有统计学意义(t=-23.65,P<0.01)。结论双能量头颅CTA虚拟平扫可以用于诊断颅内出血,而且可有效的减少病人接受的辐射剂量。Objective The Preliminary study was to assess the feasibility of dual-energy CT（DE-CT） with its virtual non-enhanced computed tomography（VNCT） in diagnosis of intracranial hemorrhage.Methods In total 60 patients were included in the study;all of patients underwent conventional non-enhanced brain CT（CNCT） and DE-CT angiography（DE-CTA）.The virtual non-enhanced images and the conventional images related to the presence of intracranial hemorrhage were evaluated by a radiologist.The findings variability was assessed using x2 test and kappa test.Kappa values were calculated to determine interobserver agreement about images quality of VNCT.Sensitivity,specificity and positive and negative predictive values for intracranial hemorrhage presence were determined.60 patients who underwent conventional CTA were recruited as a control group;the independent-sample t test was used to compare individual radiation dose exposure between DE-CTA and conventional CTA.Results The difference was no significant（P0.05） between in detection of intracranial hemorrhage on virtual and conventional unenhanced images and the agreement was good（kappa=0.721,P0.01）.With CNCT as the standard of reference,the sensitivity,specificity,and positive and negative predictive values of VNCT in the detection of intracranial aneurysm were 95.6%,73.3%,91.5%,and 84.6%.The individual radiation dose exposure with DE-CTA dose length product（2.36±0.28） mSv was lower obviously compare with conventional CTA（4.20±0.53） mSv with showing a statistically significant difference（t=-23.65,P0.01）.Conclusion DECTA with its virtual unenhanced images is sufficient for the detection of intracranial hemorrhage,and decreases the patients＇ radiation dose effectively.

关 键 词：体层摄影术 X线计算机 双能 颅内出血 虚拟图像 

分 类 号：R591.49[医药卫生—内科学] R445.2[医药卫生—临床医学]