双低剂量技术在双能量头颈部CT血管成像中的应用  

Application of Dual Low-dose Technique in Dual-energy Head and Neck CT Angiography

作　　者：刘利[1] 计一丁 张亦弛 迟婧 尹胜男[1] 丁宁[1] LIU Li;JI Yi-ding;ZHANG Yi-chi;CHI Jing;YIN Sheng-nan;DING Ning(Department of Radiology,Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou 215000,Jiangsu Province,China)

机构地区：[1]苏州大学附属苏州九院影像科,江苏苏州215000

出　　处：《中国CT和MRI杂志》2024年第6期43-46,共4页Chinese Journal of CT and MRI

基　　金：江苏省医学会伦琴影像科研专项资金项目SYH-3201150-0018(2021013);苏州市临床重点病种诊疗专项项目LCZX202025。

摘　　要：目的 探讨双低剂量扫描技术在双能量头颈部CTA扫描中的可行性。方法 前瞻性收集2021年1月~2021年5月间本院102名因头颈部血管疾病行头颈部CTA的患者纳入研究,随机分为CD、DLD两组,CD组行常规剂量扫描,DLD组行双低剂量扫描;分别对两组图像行MIP、VR、 MPR、 CPR、双能量去骨去钙化等后处理,用5分法对两组图像质量进行主观评价,选取颈总动脉起始部、颈内动脉起始部和大脑中动脉M1段测量血管的噪声、SNR、CNR,记录2组患者的x线剂量参数,包括CTDIvol(mGy)和DLP(mGy·cm),计算其有效剂量ED(mSv),亦计算2组患者的碘摄入量I(mg),对结果进行统计学分析。结果 CD组与DLD组的主观图像质量评分均≥3分,均能满足诊断的要求。2名医师对2组图像质量评价的一致性好(Kappa值分别为0.817、0.82 5)。2名医师对2组图像的主观质量评分的差异无统计学意义(Z=-0.572、-0.2 83,均P>0.05)。CD组与DLD组图像各层面血管CT值的差异均无统计学意义(t=-0.05、0.689、0.906,均P<0.05);颈内动脉起始部、大脑中动脉M1段层面血管噪声、SNR、CNR的差异均无统计学意义(t=-0.830~1.842,均P>0.05);颈总动脉起始部层面CD组噪声大于DLD组(t=2.855,P<0.05),SNR、CNR小于DLD组(t=-4.959、-5.041,均P<0.05)。DLD组患者C TDIvol、DLP及ED较CD组分别降低36.9%、35.3%、35.2%(t=186.138、37.753、37.753,均P<0.05)。DLD组患者碘摄入量较CD组降低57.1%(10.5g VS.245g)。结论 双低剂量双能量头颈部CTA扫描技术在不影响图像质量的前提下,降低了患者接受的辐射剂量和对比剂碘摄入量。Objective To study the feasibility of dual-source CT double low-dose scanning technology in dual-energy head and neck CTA.Methods A total of 102 patients with CTA due to vascular diseases of the head and neck in our hospital from January 2021 to May 2021 were prospectively collected and included into the study,and randomly divided into CD and DLD groups.The CD group underwent conventional dose scanning(tube voltage 100/Sn140kV,pitch 0.9,70mL contrast agent),and the DLD group underwent double low dose scanning(tube voltage 80/Sn140kV,pitch 1.2,P<0.05).The CD group underwent FBP reconstruction,linear fusion(M=0.6) to obtain the equivalent 120kV image,the DLD group underwent SAFIRE ite rative reconstruction(ite rative intensity level 3),and the 65keV energy spect rum was obtained by virtual monoenergetic technology.The two groups of images were processed with dual energy bone removal and calcification,MIP,VR,MPR,CPR and other post-processing technique.The X-ray dose parameters of the two groups were recorded,including CTDIvol(mGy) and DLP(mGy·cm),and the effective dose ED(mSv) was calculated.The iodine ingestion of the two groups was calculated,and the image quality of the two groups was evaluated subjectively and objectively,and the results were statistically analyzed.Results The image quality scores of CD group and DLD group were both≥3,which could meet the requirements of diagnosis.The two radiologists had good consistency in image quality evaluation of the two groups(Kappa values were 0.817 and 0.825).There was no significant difference in subjective image quality scores between the two groups(Z=-0.572,-0.283,both P>0.05).There was no significant difference in the CT value of blood vessels at each level between the CD group and the DLD group(t=-0.705,0.689,0.906,all P>0.05).There was no significant difference in vessel noise,SNR and CNR between the initial part of internal ca rotid artery and the M1 segment of middle ce rebral artery(t=-0.830~1.842,all P>0.05).However,the noise of the initial part of the comm

关 键 词：低剂量 双能量成像 头颈部CTA 虚拟单能谱 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]