能谱CT单能量图像在主动脉夹层诊断中的应用价值  

Application value of spectral CT single energy image in the diagnosis of aortic dissection

作　　者：欧阳子健 慕鉴 罗鹏飞 李俊 何飞[1] 韦学[1] OUYANG Zijian;MU Jian;LUO Pengfei;LI Jun;HE Fei;WEI Xue(Department of Radiology,the Second Nanning People′s Hospital,Nanning 530031,Guangxi,China)

机构地区：[1]广西南宁市第二人民医院放射科,广西南宁市530031

出　　处：《广西医学》2023年第11期1287-1290,共4页Guangxi Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20221136)。

摘　　要：目的探讨能谱CT单能量图像在主动脉夹层诊断中的应用价值。方法纳入34例经CT血管造影(CTA)确诊且游离内膜瓣无钙化的主动脉夹层患者及51例非主动脉夹层者,均行能谱CT平扫检查。利用主动脉夹层患者能谱CT平扫数据,重建出40 keV、60 keV、80 keV、100 keV、120 keV、140 keV 6组图像,以真腔CT值、假腔CT值与内膜瓣CT值的差值最大时的keV值作为显示主动脉夹层内膜瓣的最佳keV条件。以CTA结果为金标准,计算重建的单能量图像(最佳keV条件下)、未重建的混合能量图像诊断主动脉夹层的准确度、灵敏度、特异度、阳性预测值及阴性预测值。结果40 keV为最佳keV条件。40 keV单能量图像诊断主动脉夹层的灵敏度>80%,特异度和准确度均>90%,且灵敏度、准确度、阴性预测值均高于混合能量图(均P<0.05)。结论40 keV条件下的能谱CT单能量图像对主动脉夹层内膜瓣的显示效果最佳,该图像对主动脉夹层具有较高的诊断效能。Objective To investigate the application value of spectral CT single energy image in the diagnosis of aortic dissection.Methods Thirty-four aortic dissection patients with confirmed diagnosis by computed tomography angiography(CTA)and without calcification in free intimal flap,and 51 individuals without aortic dissection were enrolled,and all cases received examination of spectral CT plane scan.Six sets of images of 40 keV,60 keV,80 keV,100 keV,120 keV,and 140 keV were reconstructed by using the data of spectral CT plane scan in patients with aortic dissection,and the keV value with the largest difference between the CT value of the true lumen,the CT value of the false lumen and the intimal flap CT value was used as the optimal keV criteria for displaying intimal flap of aortic dissection.Using CTA result as the golden standard,the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of reconstructed single energy image(at the optimal keV condition),and of unreconstructed mixed energy image for diagnosing aortic dissection were calculated.Results The optimal keV condition was 40 keV.The sensitivity of 40 keV single energy image in the diagnosis of aortic dissection was more than 80%,the specificity and accuracy were more than 90%,and the sensitivity,accuracy and negative predictive value were higher than those of mixed energy image(all P<0.05).Conclusion Single energy image of spectral CT at 40 keV criteria obtains the optimal effect for displaying intimal flap of aortic dissection,and this image exerts relatively high diagnostic efficiency for aortic dissection.

关 键 词：主动脉夹层 能谱CT 单能量图像 诊断效能 

分 类 号：R445.3[医药卫生—影像医学与核医学]