能谱CT联合ASIR-V及双低对比剂在肝硬化门静脉成像中应用价值研究  

Study on the Application Value of Energy Spectrum CT Combined with Hybrid Model-Based ASIR-V and Double-Low Contrast Agents in Portal Vein Imaging of Cirrhosis

作　　者：邓建涛 严高武 马婷 范小萍[1] 李勇 DENG Jiantao;YAN Gaowu;MA Ting;FAN Xiaoping;LI Yong(Department of Radiology,Suining Central Hospital,Suining Sichuan 629000,China)

机构地区：[1]遂宁市中心医院放射影像科,四川遂宁629000

出　　处：《中国医疗设备》2022年第9期69-75,共7页China Medical Devices

基　　金：四川省卫生健康委员会科研课题(19PJ284)。

摘　　要：目的探讨不同权重的多模型迭代重建(Adaptive Statistical Iterative Reconstruction-V,ASIR-V)技术联合低用量、低浓度对比剂在肝硬化患者能谱门静脉成像中的可行性,以获得门静脉的最佳单能量与迭代重建权重组合。方法前瞻性连续收集临床拟诊断为肝硬化需行CT门静脉成像的患者80例,并按随机数字表法分为A组和B组,每组40例。其中A组使用碘帕醇370 mgI/mL,常规管电压120 kV扫描,ASIR-V 40%重建;B组使用碘海醇300 mgI/mL,能谱扫描。测量门静脉主干最大层面的CT值和噪声值,以上述层面的肝脏和竖脊肌为组织背景,分别测量肝脏实质和竖脊肌的CT值及标准差,计算门静脉信噪比(Signal to Noise Ratio,SNR)和对比噪声比(Contrast to Noise Ratio,CNR)。比较和评价对比剂用量、碘摄入量、辐射剂量、图像质量。结果当单能量能级不变时,图像的SNR和CNR随着ASIR-V迭代率的增加而增加,噪声显著降低(P<0.05);迭代重建权重为60%时,门静脉图像的SNR及CNR高于滤波反投影组和ASIR-V 20%、40%组的图像(P<0.05);60 keV组门静脉图像主观评分高于其他单能量组,差异有统计学意义(P<0.05);B组中的60 keV、ASIR-V 60%组门静脉图像的客观评价与主观评分均高于A组,B组对比剂总量较A组减少约15.57%,碘摄入量较A组减少约31.56%(P<0.001)。结论肝硬化患者采用60 keV单能量图像+ASIR-V 60%的迭代权重组合联合双低对比剂行门静脉CT血管成像,可以获得满足临床需求的图像质量,同时降低了对比剂的浓度和剂量。Objective To explore the feasibility of hybrid model-based adaptive statistical iterative reconstruction-V(ASIR-V)with different weights in combination with low-dose and low-concentration contrast agents in spectral portal imaging for liver cirrhosis,and to obtain the optimal combination of spectral monochromatic images and iterative reconstruction weight of portal vein.Methods A total of 80 patients who were to be diagnosed with cirrhosis requiring CT portal vein imaging were prospectively and continuously collected and divided into group A and group B,with 40 cases in each group.In group A,iopamidol 370 mgI/mL was used with conventional tube voltage 120 kV scanning and ASIR-V 40%reconstruction;while in group B,iohexol 300 mgI/mL was used with energy spectrum scanning.The CT value and noise value at the largest slice of the main portal vein were measured.With the liver and erector spinae at the above slice as tissue background,the CT value and standard deviation value of liver parenchyma and erector spinae were measured,respectively,to calculate the signal to noise ratio(SNR)and contrast to noise ratio(CNR)of the portal vein.Contrast agent dose,iodine intake,radiation dose and image quality were evaluated and compared between two groups.Results When the monoenergetic level was constant,the SNR and CNR of the image increased with the increase of the ASIR-V iteration rate,and the noise was significant reduced(P<0.05).When the weight of iterative reconstruction was 60%,the SNR and CNR of portal vein images were higher than those of filter back projection group and ASIR-V 20%and 40%group(P<0.05).The subjective score of portal vein image in 60 keV group was higher than that of other monoenergetic groups,and the difference was statistically significant(P<0.05).The objective evaluation and subjective scores of portal vein images in the 60 keV and ASIR-V 60%groups in group B were higher than those in group A.The total amount of contrast medium in group B was reduced by about 15.57%compared with that in group A,and the i

关 键 词：能谱CT 单能量成像 迭代重建 门静脉 对比剂 

分 类 号：R445.3[医药卫生—影像医学与核医学]