肝脏占位病变能谱CT成像中不同期相虚拟平扫替代真实平扫的效能及方案选择  

Feasibility and Protocol Selection of Virtual Non-Contrast Technology Replacing True Non-Contrast Scanning in Tri-Phase of Liver Lesions with Spectral CT

作　　者：顾芳燕 朱晓梅[2] 聂芳[1] 王威 GU Fangyan;ZHU Xiaomei;NIE Fang;WANG Wei(Department of Radiology,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]东南大学附属中大医院放射科,江苏南京210009 [2]江苏省人民医院放射科,江苏南京210029

出　　处：《中国医学影像学杂志》2024年第8期809-815,共7页Chinese Journal of Medical Imaging

摘　　要：目的基于肝脏病变,探讨Revolution CT不同期相虚拟平扫(VNC)与真实平扫(TNC)的等效性及影响因素。资料与方法回顾性收集东南大学附属中大医院2021年12月—2022年4月行肝脏平扫及动脉(A)、静脉(V)及延迟(D)三期能谱增强的62例患者,测量直径≥5 mm的肝脏病灶,按TNC的CT值分为1组(≤20 Hu)及2组(>20 Hu),按强化程度分为a组(三期增强强化程度均≤20 Hu)和b组(三期增强中至少有一期强化程度>20 Hu),分别比较TNC和三期VNC组病灶的CT值、最大径及病灶检出率,使用多因素回归分析观察VNC与TNC CT值差值的影响因素。结果各组病灶CT值差异有统计学意义(χ^(2)/F=14.712、18.603、7.334,P均<0.01),仅1a组病灶VNCV和VNCD与TNC差异无统计学意义(P均>0.05),其余病灶与TNC相比,a类病灶VNC偏低,b类病灶VNC偏高(P均<0.05)。各组病灶VNCA和VNCV与TNC的最大径差异无统计学意义且呈极强相关(P均>0.05;r均>0.8,P均<0.001)。4组检出率差异有统计学意义(χ^(2)=47.660,P<0.001),VNCV高于VNCA及VNCD(P均<0.05)。VNC与TNC的CT值差值与增强CT值呈正相关(r^(2)_(修正)=0.209、0.142、0.062,P均<0.001)。结论对于肝脏病变,Revolution CT静脉期VNC是替代TNC的最佳期相,并能通过静脉期CT值行一定矫正。Purpose Based on liver lesions,to investigate the feasibility and influencing factors of virtual non-contrast(VNC)replacing true non-contrast(TNC)in tri-phase derived from Revolution CT.Materials and Methods A total of 62 patients who underwent TNC and tri-phase(arterial,venous,and delayed phases)spectral enhanced liver scans were retrospectively enrolled in Zhongda Hospital Affiliated to Southeast University from December 2021 to April 2022.Liver lesions with a diameter of≥5 mm were measured and categorized into Group 1(≤20 Hu)and Group 2(>20 Hu)according to the CT values of TNC,then were respectively further categorized into group a(≤20 Hu across all three phases of enhancement)and group b(>20 Hu in at least one phase of enhancement)based on the degree of enhancement.CT attenuation,maximum diameter and detection rates of lesions were compared between TNC and three-phase VNC groups.Multivariate regression analysis was used to investigate the influencing factors of the density difference between VNC and TNC.Results A statistically significant difference in the attenuation of lesions was observed among the each groups(χ^(2)/F=14.712,18.603,7.334,all P<0.01).Except for VNCV and VNCD in Group-1a which had no significant difference with TNC(both P>0.05),the attenuation of other VNCs were lower than TNC in category-a and greater than TNC in category-b(all P<0.05).Maximal diameter presented strong correlation and no significant difference in VNCA and VNCV compared to TNC in each group(all P>0.05;all r>0.8 and P<0.001).A significant difference in the detection rate of the lesions was observed among the groups(χ^(2)=47.660,P<0.001),VNCV images displayed the higher detection rate than VNCA and VNCD(all P<0.05).The density difference between VNC and TNC was positively correlated with CT values of the corresponding enhancement phase(r^(2)_(adjusted)=0.209,0.142,0.062,P<0.001).Conclusion Based on Revolution CT,VNCV is the optimal phase to replace TNC and can be mitigated by CT value of the lesions in venous-phase.

关 键 词：体层摄影术 X线计算机 肝疾病 虚拟平扫 可行性分析 

分 类 号：R575[医药卫生—消化系统] R445.3[医药卫生—内科学]