低剂量双源CT扫描在腹部三期增强检查中的应用效果  

Application effect of low-dose dual-source CT scan in abdominal three-phase enhanced examination

作　　者：张紫瑞[1] 盛美红[1] 李飞 ZHANG Zi-rui;SHENG Mei-hong;LI Fei(Department of Imaging,Second Affiliated Hospital of Nantong University,Nantong Jiangsu 226001,China)

机构地区：[1]南通大学第二附属医院影像科,江苏南通226001

出　　处：《局解手术学杂志》2023年第5期400-403,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(81702216)。

摘　　要：目的探讨低剂量双源CT扫描在腹部三期增强检查中的应用效果。方法回顾性分析我院140例疑似肝癌患者的临床资料,患者均行双源CT腹部三期增强检查,根据增强扫描中能量和碘海醇剂量的不同将其分为A1组(低能量低剂量,80 keV、270 mgI/mL)37例、A2组(低能量高剂量,80 keV、350 mgI/mL)35例、B1(高能量低剂量,140 keV、270 mgI/mL)40例、B2组(高能量高剂量,140 keV、350 mgI/mL)28例。采用图像质量主观评分和客观评分[信噪比(SNR)]评估各组图像质量,计算各组图像的有效照射剂量[剂量长度乘积(DLP)及有效剂量(ED)]。以病理检查结果为金标准,评估低剂量双源CT腹部三期增强扫描诊断肝癌的价值。结果各组图像可清晰显示血管及脏器组织,均达到诊断要求。各组在动脉期和门静脉期的图像质量主观评分比较差异无统计学意义(P>0.05)。各组动脉期和门静脉期腹主动脉腹腔干、腹腔动脉干、肠系膜上动脉、门静脉主干图像SNR比较,差异具有统计学意义(P<0.05),且A1组所得图像SNR明显高于其他组(P<0.05)。各组腹部增强扫描的DLP及ED比较差异具有统计学意义(P<0.05),且A1组DLP及ED明显低于其他组(P<0.05)。140例疑似肝癌患者经病理确诊为肝癌79例,低剂量双源CT腹部三期增强扫描诊断出75例,诊断的敏感度、特异度和准确度分别为86.07%、91.80%和88.57%,Kappa值为0.769。结论低剂量双源CT腹部三期增强扫描在80 keV的低能量行单能量重建获得的图像质量最佳,具有较高的敏感度、特异度及准确度,可满足影像诊断的要求,安全性高。Objective To explore the application effect of low-dose dual-source CT scan in abdominal three-phase enhanced examination.Methods A retrospective analysis was performed on the clinical data of 140 patients with suspected liver cancer in our hospital.All patients underwent dual-source CT scan abdominal three-phase enhanced examination,and 37 cases were included into the group A1(with low energy of 80 keV and low dose of 270 mgI/mL),35 cases were included into the group A2(with low energy of 80 keV and high dose of 350 mgI/mL),40 cases were included into the group B1(with high energy of 140 keV and low dose of 270 mgI/mL)and 28 cases were included into the group B2(with high energy of 140 keV and high dose of 350 mgI/mL)according to energy and iohexol dose in enhanced scan.The image quality of each group was evaluated by subjective score and objective score with signal-to-noise ratio(SNR).The effective radiation doses including dose length product(DLP)and effective dose(ED)in each group were calculated.The value of low-dose dual-source CT scan abdominal three-phase enhanced examination in the diagnosis of liver cancer was evaluated by taking pathological examination results as the gold standard.Results The images of each group could clearly show blood vessels and tissues of organs,which met the diagnostic requirements.There was no significant difference in the subjective scores of image quality in the arterial phase or portal vein phase among groups(P>0.05).There were significant differences in SNR of images in abdominal aorta celiac trunk,celiac artery trunk,superior mesenteric artery and main trunk of portal vein at arterial phase and portal vein phase among groups(P<0.05),and SNR of images in group A1 was significantly higher than that in other groups(P<0.05).There were significant differences in DLP and ED during abdominal enhanced scan among groups(P<0.05),and DLP and ED of group A1 were significantly lower than those of other groups(P<0.05).Among the 140 patients with suspected liver cancer,79 cases were diag

关 键 词：双源CT 低剂量扫描 腹部三期增强检查 图像质量 

分 类 号：R735.7[医药卫生—肿瘤] R445.3[医药卫生—临床医学]