能谱CT虚拟平扫成像在尿路造影中替代常规平扫的可行性研究  

Virtual non-contrast CT imaging replaces the conventional non-contrast CT imaging in urography: a feasibility study

作　　者：张进[1] 李小虎[1] 余玲[1] 束宏敏 刘斌[1] Zhang Jin;Li Xiaohu;Y u Ling(Dept of Radiology ,The First Affiliated Hospital of Anhui Medical University,Hefei 23002)

机构地区：[1]安徽医科大学第一附属医院放射科,合肥230022

出　　处：《安徽医科大学学报》2018年第4期595-599,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校省级自然科学研究重点项目(编号:KJ2013A144)

摘　　要：目的探讨在CT泌尿系成像中能谱CT虚拟平扫(VNC)替代真实平扫(TNC)的可行性。方法本文共入组24例患者,分别测量并比较TNC和VNC两组图像的客观指标(噪声、对比噪声比、辐射剂量、结石大小及检出率)及两位医师对图像质量主观评分值。客观指标运用配对t检验,图像质量主观评价结果运用秩和检验方法进行统计学分析。结果 VNC图像肾皮质噪声值为(10.31±2.34),肾髓质噪声值为(10.64±2.76),肾皮质对比噪声比为(2.37±0.98),肾髓质对比噪声比为(2.14±1.08);TNC图像肾皮质噪声值为(9.56±1.46),肾髓质噪声值为(9.46±1.57),肾皮质对比噪声比为(2.42±0.97),肾髓质对比噪声比为(2.40±1.14);VNC和TNC图像的噪声及对比噪声比差异均无统计学意义。能谱CT虚拟平扫CT尿路造影患者接受的有效辐射剂量为(16.04±1.84)m SV,常规CT尿路造影检查患者接受的有效辐射剂量为(21.60±2.37)m SV,差异有统计学意义(P<0.05),有效辐射剂量减少了25.74%。≥3 mm的结石在TNC和VNC图像上直径差异无统计学意义,3 mm以上结石在VNC图像上的检出率达到90%以上,3 mm以下较小结石VNC完全未检出。两位放射科医师对TNC和VNC图像质量评价具有高度一致性,Kappa值均>0.6,主观评分均≥3分。结论 CT泌尿系成像中,能谱CT虚拟平扫替代常2017-12-21接收规平扫,可在图像质量满足临床诊断需求下有效减少辐射剂量。Objective To investigate the feasibility of virtual non-contrast CT images instead of conventional noncontrast CT images in CT imaging of urinary system. Methods 24 patients were enrolled in this study. The objective parameters（ noise,contrast-to-noise ratio,radiation dose,stone size） and the subjective score of two doctors were measured and compared in the two groups of non-contrast scan and discharge stage virtual non-contrast scan respectively in field of vision. Paired t test was used for analysis of objective indexes and rank sum test was used for analysis of subjective scores of image quality. Results In virtual non-contrast CT images,the renocortical noise was（ 10. 31 ± 2. 34）,the renal medullary noise was（ 10. 64 ± 2. 76）,the contrast to noise ratio of cortex renis was（ 2. 37 ± 0. 98） and the contrast to noise ratio of renal medullary was（ 2. 14 ± 1. 08）. In conventional non-contrast CT images,the renocortical noise was（ 9. 56 ± 1. 46）,the renal medullary noise was（ 9. 46 ± 1. 57）,the contrast to noise ratio of cortex renis was（ 2. 42 ± 0. 97） and the contrast to noise ratio of renal medullary was（ 2. 40 ±1. 14）. There was no significant difference in contrast to noise ratio and the noise between virtual non-contrast CT images and conventional non-contrast CT images. The effective radiation dose received by virtual non-contrast scan patients was（ 16. 04 ± 1. 84） m SV. The effective radiation dose received by the conventional non-contrast scan is（ 21. 60 ± 2. 37） m SV,and the CTDIvol,DLP and ED of the virtual non-contrastscan were lower than those of the conventional non-contrast scan,and the difference was statistically significant（ P 0. 05）. The effective radiation dose of the CT enhanced scan was reduced by 25. 74% compared with the conventional scan and enhancement scan alone. In addition,more than 3 mm stones in the conventional non-contrast scan and virtual non-contrast images on the diameter of the difference was not statistically significant

关 键 词：泌尿系疾病 X线计算机 能谱CT 虚拟平扫 辐射剂量 

分 类 号：R814.42[医药卫生—影像医学与核医学] R692.4[医药卫生—放射医学]