能谱CT结合探针技术在椎动脉闭塞血管评价中的应用价值  

Value of energy CT combined with probe technique in evaluating vertebral artery occlusion

作　　者：韩旭 张焕 陈杰[1] 武晔 王志群 崔斌[1] Han Xu;Zhang Huan;Chen Jie;Wu Ye;Wang Zhiqun;Cui Bin(Department of Radiology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院影像科,北京100049

出　　处：《中华老年心脑血管病杂志》2022年第4期339-342,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：中国航天科工集团公司2018年医疗卫生科研项目(2018-LCYL-001)。

摘　　要：目的 探寻能谱CT结合探针技术在优化椎动脉闭塞段血管显示及闭塞段成分分析的应用研究。方法 收集脑血管病事件接受头颈CT血管造影检查确诊的慢性椎动脉闭塞患者25例,采用双源双能CT新虚拟单能量成像技术分别获得40~100 keV(间隔10 keV)7个单能量图像,并以常规90 kV作为质量控制图像,比较各能级图像间信噪比、对比噪声比及平均噪声。利用探针技术分别测量椎动脉闭塞近段血管0、5、10 mm处管腔内碘浓度、脂质含量及能谱曲线,分析不同分段测量值差异及曲线变化。结果 40~100 keV单能图像及90 kV共8个图像椎动脉闭塞段信噪比、对比噪声比和平均噪声比较,差异有统计学意义(P<0.01)。其中80 keV图像信噪比最高(5.43±2.39)、对比噪声比最大(3.48±1.52)。80 keV图像平均噪声明显低于40 keV、50 keV、60 keV、70 keV、90 kV图像,差异有统计学意义(P<0.05)。椎动脉闭塞近、中、远不同节段碘浓度及脂质含量比较,差异有统计学意义(P<0.01)。椎动脉闭塞近段弓背向上型曲线发生率较中段和远段明显升高,差异有统计学意义(P=0.004)。结论 80 keV双源双能CT新虚拟单能量成像可以提高头颈CT血管造影中椎动脉闭塞段图像质量;判别闭塞段管腔内脂质含量和碘浓度是否存在梯度变化,并结合能谱曲线分析,推测血管闭塞的原因。Objective To study the value of energy CT combined with probe technique in optimizing the display of vertebral artery occlusion and analyzing its segment components.Methods Twenty-five chronic vertebral artery occlusion patients who underwnet head and neck CT angiography for cerebrovascular disease were included in this study.Seven single 40-100 keV energy images at an interval of 10 keV achieved using the new virtual single energy technology of dual energy CT with conventional 90 kV image were used as the quality control images.The signal to noise ratio(SNR),contrast to noise ratio(CNR) and average image noise of different images were compared.The iodine concentration, lipid content and energy spectral curve in proximal segments(0,5,10 mm) of vertebral artery occlusion were measured using the probe technique.The values and curve variations in different vertebral artery occlusion segments were analyzed.Results Significant difference was detected in SNR,CNR and average image noise on 40-100 keV and 90 kV images(P<0.01).Of the SNR,CNR and average image noise on 40-100 keV and 90 kV images, the SNR and CNR were higher(5.43±2.39,3.48±1.52) while the average image noise was lower on 80 keV image than on 40 keV,50 keV,60 keV,70 keV and 90 kV images(P<0.05).The iodine concentration and lipid content in proximal, middle and distal segments of vertebral artery occlusion were significantly different(P<0.01).The incidence of hump up curve was significantly higher in the proximal segment of vertebral artery occlusion than in the middle and distal segments of vertebral artery occlusion(P=0.004).Conclusion The 80 keV dual energy CT can improve the head and neck CT angiography image quality of vertebral artery occlusion segments, identify the gradient change of lipid content and iodine concentration in different segments of vertebral artery occlusion and predict vertebral artery occlusion in combination of energy spectral curve analysis.

关 键 词：体层摄影术 X线计算机 椎底动脉供血不足 动脉闭塞性疾病 动脉粥样硬化 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]