双源CT小肠造影双能量虚拟平扫的临床评估  

Clinical evaluation of dual-source CT enterography using dual-energy virtual non-enhanced technique

作　　者：邓丽萍[1] 史晓喆[1] 章士正[1] 张峭巍[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院放射科,杭州310016

出　　处：《放射学实践》2014年第12期1439-1442,共4页Radiologic Practice

基　　金：浙江省科技计划项目(2011C37015)

摘　　要：目的:探讨64排双源CT小肠造影双能量虚拟平扫技术应用于临床的可行性。方法:采用双源CT机对39例患者进行小肠造影检查,常规行CT平扫以及动、静脉期对比增强双能量扫描(100kVp/230mAs和l40kVp/178mAs)。利用Liver VNC软件进行后处理,获得动、静脉期的虚拟平扫CT图像。以常规CT平扫图像作为标准,对虚拟平扫图像的质量进行评估,采用4级评分法:最高为4分(图像解剖细节清晰,完全能满足诊断),最低为1分(图像模糊,不能满足诊断)。并对常规CT平扫、动、静脉期双能量CT扫描的辐射剂量进行比较。结果:39例中有腹部病变者25例,无明显异常者14例。与常规平扫图像比较,虚拟平扫图像上所有病灶均能显示,且病灶的范围、大小亦无明显差异;两位医师对虚拟平扫图像质量的评分均>2分,两者的评分差异无统计学意义(P>0.05)。所有虚拟平扫图像完全能满足诊断要求。常规平扫、双能量动脉期、双能量静脉期扫描的剂量长度乘积(DLP)分别为(283.8750±57.1195)、(289.3750±53.1543)和(301.2917±55.3346)mGy·cm,三次扫描的DLP的差异无统计学意义(F=0.615,P=0.544)。结论:双源CT小肠造影检查时可仅进行双能量增强扫描,经后处理获得的虚拟平扫图像基本可取代常规CT平扫,从而可减少检查的辐射剂量。Objectire：To investigate the clinical feasibility of dual-source CT enterography using dual-energy virtual non-enhanced CT （VNCT）technique.Methods：CT enterography were performed in 39 patients with dual source CT scan-ner,including conventional non-enhanced CT scan （CNCT）,arterial and venous phase contrast-enhanced CT scan （CECT） with dual energy mode （100kVp/230mAs and 140kVp/178mAs）.VNCT images of arterial and venous phase were obtained after being post-processed with Liver-VNC software.Using CNCT as a standard,the image quality of VNCT images were evaluated and scored with 1～4 grade scoring system （the higher score indicated better image quality：4 scores means per-fect,1 score means unsatisfactory for diagnosis）.The radiation dose of CNCT,arterial and venous phase CECT was com-pared.Results：Of 39 patients,there were 25 cases with lesions and 14 cases of normal.Compared with CNCT images,all the lesions were also detected accurately by VNCT images,and there was no significant difference of size and extent of lesions between CNCT and VNCT.The scores of VNCT images were all higher than 2,there was no significant statistic difference between the score of two doctors,and the image quality of VNCT images met the requirement of diagnosis.The average dose length product （DLP）of conventional non-enhanced CT,arterial and venous phase CECT were （283.8750±57.1195）, （289.3750±53.1543 ）and （301.2917 ± 55.3346 ）mGy ＆#183; cm respectively,with no statistic difference （F = 0.615,P =0.544）.Conclusion：Dual energy CT virtual non-enhanced images may replace true non-enhanced images in CT enterography and then can reduce radiation dose of examination.

关 键 词：小肠疾病 体层摄影术 X 线计算机 小肠造影 虚拟平扫 

分 类 号：R816.5[医药卫生—放射医学]