炫速双源CT双能量虚拟平扫在肝脏扫描应用的初步研究  

Scanning of the liver with virtual non-contrast technology of flash dual-source CT：a preliminary study

作　　者：齐晓辉[1] 时高峰[1] 王琦[1] 杜煜[1] 吴润泽[2] 刘兴龙[2] 

机构地区：[1]河北医科大学第四医院暨河北省肿瘤医院CT室,河北石家庄050011 [2]西门子中国有限公司

出　　处：《实用放射学杂志》2013年第3期396-399,432,共5页Journal of Practical Radiology

摘　　要：目的 探讨炫速双源CT （flash dual-source computed tomography, DSCT）双能量虚拟平扫在肝脏临床应用的可行性。方法 对30例临床拟诊上腹部病变患者行DSCT上腹部真实平扫及动脉期、门静脉期双能量扫描（100 kV/230 mAs和140 kV/178 mAs），利用Liver VNC软件处理分别得到动脉期、门静脉期2组虚拟平扫数据,并与CNCT对照,比较三者在平均CT值、信噪比（SNR）、图像质量、病灶检出率、病变CT值及辐射剂量的差异有无统计学意义。结果 3次扫描患者虚拟平扫图像肝脏、脾脏平均CT值大于真实平扫（P=0.00）;虚拟平扫图像SNR低于真实平扫组, 2组虚拟平扫之间差异无统计学意义（P〉0.05）；虚拟平扫的图像质量均可满足临床诊断需求;门脉期虚拟平扫和真实平扫病灶检出率差异无统计学意义，且高于动脉期虚拟平扫的病变检出率。虚拟平扫图像测量病变CT值与真实平扫之间差异无统计学意义（P〉0.05）。两期扫描患者接受的剂量明显低于常规三期扫描的剂量（t=0.953,P=0.000）。结论 虽然虚拟平扫的CT值、SNR及图像质量低于真实平扫，但并不影响诊断及病变的检出，且可以减少患者的接受剂量，门脉期虚拟平扫病变检出率高于动脉期，因此可以采用门脉期虚拟平扫图像代替真实平扫。Objective To probe the feasibility of liver scanning with virtual non-contrast technology（VNC）of flash dual-source CT. Methods Abdominal CT scans were performed in 30 patients with suspected intrahepatic lesions using conventional CT （CNCT} , arterial and portal phase enhancement scan with dual energy mode （100kV/230mAs and 140kV/178mAs）. The liver VNC software was used to reformat virtual non-enhanced CT with the arterial and portal phase date respectively. Image quality, radiation dose, the average CT value,signal to noise ratio（SNR） ,and lesion detectability were compared. Results The mean H U of liver and spleen on VNC images are larger than real native images. Mean HU of liver and spleen on real native images were （53. 6±8. 50） ,（45.82±4.77） HU;which were （59.74±7.50）,（54.52±4.42） HU on arterial phase VNC images; （61. 66±7. 90） , （54. 17±3.95} HU on portal venous phase VNC images （P〈0. 001. Real native images SNR of liver,spleen and artery were 13.11±5.87,9. 77±3. 50,10. 32±4.42; arterial phase VNC images SNR were 9. 10±4.01,8.26±3.43,6.86±3. 25 ; portal venous phase VNC images SNR were 9. 77±3.50 , 8. 51± 2.7,6.64±2. 15（P=0.00）. There is no statistical significant in the SNR between arterial phase VNC and portal venous phase VNC （P〉0.05）. Image quality of VNC can be used for diagnosis. There is no statistical significant in diagnosis accuracy between portal venous phase VNC and real native images （P=0. 325 ）. Mean effective dose for dual-phase scanning wasT. 84±1.52mSv and that for three-phase scanning was 12.3t 1.94mSv. Radiation dose of dual-phase scanning was lower than routine three-phase scanning obviously（ t-0. 953, P = 0. 000）. Conclusion Although CT value, SNR and image quality of VNC are lower than real native images, there is no statistical difference in diagnosis accuracy and radiation dose can be reduced by using VNC technology. It is better to remove iodine from images by using portal venous phase VNC than arterial phase

关 键 词：肝脏 双源CT 虚拟平扫 信号噪声比 辐射剂量 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]