基于去脂体质量确定肝脏双能量CT对比剂碘剂量研究  

Determination of optimal contrast media iodine dose based on lean body weight at hepatic dual-energy CT

作　　者：赵林伟[1] 李勇 董国礼[2] 杨国庆[1] 冯敏[1] 严高武 殷成坤 李娜 ZHAO Linwei;LI Yong;DONG Guoli;YANG Guoqing;FENG Min;YAN Gaowu;YIN Chengkun;LI Na(Department of Radiology,Suining Central Hospital,Suining,Sichuan Province 629000,China;Department of Radiology,the Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,China)

机构地区：[1]遂宁市中心医院放射科,四川遂宁629000 [2]川北医学院附属医院放射科,四川南充637000

出　　处：《实用放射学杂志》2022年第12期2059-2063,共5页Journal of Practical Radiology

基　　金：四川省卫生健康委员会科研课题(140107;19PJ283)。

摘　　要：目的探讨双能量CT(DECT)120 kVp融合图像中肝脏强化程度达50 HU时基于去脂体质量(LBW)调整的碘剂量。方法患者行肝脏DECT增强扫描,对比剂碘剂量17.1 g I/m2体表面积(BSA),注射时间25 s。计算每克碘肝脏平均强化(MHE/I)及基于LBW调整的肝脏平均强化[aMHE=MHE/(I/LBW)]。LBW与MHE/I相关系数的比较采用Z检验。碘剂量与MHE的关系采用线性分位数回归分析。结果80 kVp及120 kVp融合图像中,MHE/I女性组分别为(3.86±0.60)HU/g I、(2.18±0.35)HU/g I,男性组分别为(3.36±0.51)HU/g I、(1.96±0.27)HU/g I;aMHE女性组分别为(0.1449±0.0180)HU/mg I/kg LBW、(0.0821±0.0125)HU/mg I/kg LBW,男性组分别为(0.1727±0.0190)HU/mg I/kg LBW、(0.1013±0.0102)HU/mg I/kg LBW。MHE/I女性组高于男性组,aMHE女性组低于男性组(P<0.05)。120 kVp融合图像总体组、男性组、女性组碘剂量分别为571、548、608 mg I/kg LBW时,MHE第0.5分位数达50 HU;相应地,723、585、684 mg I/kg LBW可使MHE第0.25分位数达50 HU,476、498、529 mg I/kg LBW可使MHE第0.75分位数达50 HU。结论120 kVp融合图像不同分位数水平肝脏充分强化的基于LBW的碘剂量,可以作为肝脏DECT增强扫描的对比剂应用方案。Objective To determine the optimal iodine dose adjusted based on lean body weight(LBW)when achieved an enhancement of 50 HU in hepatic attenuation at blended 120 kVp of dual-energy CT(DECT).Methods All patients underwent hepatic contrast-enhanced DECT,body surface area(BSA)-tailored iodine dose of contrast media were 17.1 g I/m2,fixed injection duration were 25 s.Mean hepatic enhancement per unit of iodine(MHE/I)and adjusted mean hepatic enhancement(aMHE)[aMHE=MHE/(I/LBW)]were calculated.Linear quantile regression was performed to evaluate the relationship between iodine dose and MHE,and the correlation coefficients between LBW and MHE/I were compared with Z test.Results MHE/I showed higher in women group than in men group:80 kVp,(3.86±0.60)HU/g I vs(3.36±0.51)HU/g I(P<0.05);blended 120 kVp,(2.18±0.35)HU/g I vs(1.96±0.27)HU/g I(P<0.05).aMHE showed lower in women group than in men group:80 kVp,(0.1449±0.0180)HU/mg I/kg LBW vs(0.1727±0.0190)HU/mg I/kg LBW(P<0.05);blended 120 kVp,(0.0821±0.0125)HU/mg I/kg LBW vs(0.1013±0.0102)HU/mg I/kg LBW(P<0.05).MHE for quantile 0.5 was estimated to be 50 HU at blended 120 kVp,when the iodine doses for total population group,men group and women group were 571,548 and 608 mg I/kg LBW,respectively;corresponding,at quantile 0.25,iodine doses were 723,585 and 684 mg I/kg LBW,respectively;and at quantile 0.75,iodine doses were 476,498 and 529 mg I/kg LBW,respectively.Conclusion The required iodine dose might be determined for contrast-enhanced DECT of liver,based on the dose per unit of LBW that provided adequate hepatic enhancement in different quantile levels at blended 120 kVp.

关 键 词：对比剂 双能量CT 肝脏 计算机体层成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R322.47[医药卫生—放射医学]