碘基图在能谱CT探测肠道活动性出血中的价值——模型研究  

Evaluation of iodine-based image spectral CT for gastrointestinal bleeding:A model study

作　　者：刘文冬[1] 吴兴旺[1] 刘斌[1] 王菁 

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022 [2]合肥市滨湖医院放射科,安徽合肥230022

出　　处：《中国医学影像技术》2014年第1期122-125,共4页Chinese Journal of Medical Imaging Technology

基　　金：安徽省高校省级自然基金重点资助项目(KJ2011A179)

摘　　要：目的观察能谱CT碘基图诊断肠道活动性出血的价值。方法采用离体猪小肠制作出血模型,利用微注射器模拟0.5、0.4、0.3、0.2、0.1、0.05、0.025ml/min七种流率活动性出血,分别行能谱GSI模式及常规MSCT扫描,分别延迟15s及40s采集动脉期及门静脉期图像,利用GSI重建平台获得能谱碘基图。观察记录并比较采用常规MSCT平扫+动脉期、平扫+门静脉期图像及能谱GSI模式平扫+动脉期、平扫+门静脉期碘基图发现对比剂渗出的阳性率;测量碘基图内含碘区的碘含量(IC)及CT衰减曲线斜率(K),比较动脉期与门静脉期的差异,并分析其与出血流率的相关性。结果平扫+动脉期:常规MSCT及GSI模式扫描的阳性率分别为65.71%(23/35)、88.57%(31/35,χ2=5.185,P=0.023)。平扫+门静脉期:常规MSCT及GSI模式扫描的阳性率分别为88.57%(31/35)及100%(35/35,χ2=2.386,P=0.122)。碘基图对比剂渗出区的IC(P=0.003)和K(P=0.006)在动脉期与门静脉期差异有统计学意义,门静脉期值均明显高于动脉期。动脉期及门脉期碘基图对比剂渗出区的IC、K均与出血流率呈正相关(动脉期r=0.968,P<0.001,r=0.965,P<0.001;门静脉期r=0.964,P<0.001,r=0.956,P=0.001)。结论应用动脉期能谱CT碘基图可以提高诊断肠道活动性出血模型的阳性率。Objective To explore ~he value of iodine-based image spectral CT for gastrointestinal bleeding. Methods Contrast agent was diluted to iodine solution, in order to simulate gastrointestinal bleeding by the rate of 0.5, 0.4, 0.3, 0.2, 0. l, 0.05, 0. 025 ml/min from microinjector. GSI mode scanning and MSCT scanning （delay 15 s and 40 s） were performed for porcine small intestinal hemorrhage models with 7 hemorrhage rates, and plain imaged and enhanced imaged during arterial-phase （delay 15 s） and portal-phase （delay 40 s） were obtained. Using GSI rebuild workstation, the iodine- base image was obtained. The positive rate of ordinary M$CT, from plain image combined arterial-phase image, plain im- age combined portal-phase image, and the positive rate of GSI scanning mode, from plain image combined arterial iodine- base image, plain image combined portal iodine-base image were recorded. The positive rates of the two scanning modes were compared. The iodine base figure of iodine containing （IC） and spectal CT attenuation curve slope （K） were meas- ured, and their correlation with bleeding rate was analyzed and compared between arterial phase and portal phase. Results Plain combined arterial-phase： The positive rate of MSCT and GSI mode scanning was 65.71% （23/35） and 88.57 % （31/ 35）, respectively （g2 =5. 185, P--0. 023）. Plain image combined portal-phase： The positive rate was 88.57% （31/35） and 100% （35/35）, respectively （Z2 = 2. 386, P=O. 122）. IC and K for arterial phase and portal phase had statistical differences （P=0. 003, 0. 006）, in portal-phase were both higher. IC and K of arterial phase and portal phase both posi- tively correlated with bleeding rate （of arterial phase, r-----0. 968, P^0. 001, r----O. 965, P%0. 001~ of portal phase, r： 0. 964, P^0. 001, r-----0. 956, P ： 0. 001）. Conclusion Using arterial-phase iodine-based image of spectral CT to detect the intestinal activity bleeding can improve the positive rate of diagnosis.

关 键 词：体层摄影术 X线计算机 胃肠出血 碘基图 

分 类 号：R814.42[医药卫生—影像医学与核医学] R573.2[医药卫生—放射医学]