基于体表面积降低对比剂剂量对肝脏增强双能CT图像质量的影响  

Effect of reducing contrast agent dosage based on body surface area on the quality of liver enhanced dual-energy CT images

作　　者：雷瑜竹 李晓明 季冰 王洁 李静 陈伟 李莲 LEI Yu-zhu;LI Xiao-ming;JI Bing;WANG Jie;LI Jing;CHEN Wei;LI Lian(Department of Medical Imaging,the 79th Military Group Hospital of the Army,Liaoyang Liaoning 111000,China;Department of Radiology,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军第七十九集团军医院医学影像科,辽宁辽阳111000 [2]陆军军医大学第一附属医院放射科,重庆400038

出　　处：《局解手术学杂志》2024年第12期1048-1051,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市自然科学基金(CSTB2022NSCQ-MSX1371)。

摘　　要：目的 基于体表面积(BSA)个性化计算对比剂剂量,探究能否在减少对比剂剂量的情况下,通过双能CT获得虚拟单能量或重建融合的方法达到不影响门静脉主干增强效果的可行性。方法 选择陆军军医大学第一附属医院接受上腹部CT增强检查的60例患者,分为正常剂量组和降低剂量组。正常剂量组以BSA估算值作为对比剂剂量,降低剂量组采用BSA估算值减少20%作为对比剂剂量。2组患者门静脉期均采用双能CT扫描方式,且扫描参数相同。扫描结束后,用西门子多模图像工作站Syngo双能量后处理软件对降低剂量组门静脉期5 mm层厚图像进行“最佳对比度(OC)”和“单能量(Mono)”两种方式重建融合,测量各组图像中的门静脉主干和正常肝实质的CT值和SD值,计算出门静脉与肝实质的对比噪声比(CNR)和门静脉信噪比(SNR)。结果与正常剂量组相比,降低剂量OC组主观评分差异无统计学意义(P>0.05),但图像门静脉主干CNR、SNR显著提高(P<0.05)。降低剂量Mono组图像门静脉CT值、门静脉与肝实质差值明显低于正常剂量组,且主观评分最低,差异均具有统计学意义(P<0.05)。结论 在降低20%对比剂剂量的情况下,通过双能CT重建融合的方法,不仅能减少对比剂对患者的损害,而且可显著改善病灶显示,提高肝脏增强图像质量一致性。Objective Personalized calculation of contrast agent dose based on body surface area(BSA)was conducted to explore the feasibility of obtaining virtual single energy or reconstruction fusion through dual-energy CT without affecting the enhancement effect of portal vein trunk under the condition of reducing the contrast agent dose.Methods A total of 60 patients who received enhanced upper abdominal CT examination in the First Affiliated Hospital of Army Medical University were selected and divided into the normal dose group and the reduced dose group.The normal dose group used the BSA estimated value as the contrast agent dose,and the reduced dose group used the BSA estimated value reduced by 20%as the contrast agent dose.Both groups of patients were treated with dual-energy CT scanning in portal vein stage,and the scanning parameters were the same.After scanning,Syngo dual-energy post-processing software of Siemens multi-mode image workstation was used to reconstruct and fuse the 5 mm layer thickness image of the portal vein stage in the reduced dose group by two methods:"optimum contrast(OC)"and"monoenergetic(Mono)".The CT value and SD value of the portal vein trunk and the normal liver parenchyma of images in each group were measured.The contrast to noise ratio(CNR)of theportal vein and the liver parenchyma and portal vein signal to ratio(SNR)were calculated.Results Compared with the normal dose group,there was no statistically significant difference in the subjective score in the reduced dose OC group(P>0.05),but the CNR and SNR of the portal vein trunk in the images were significantly improved(P<0.05).The portal vein CT value and the difference between portal vein and liver parenchyma in the reduced dose Mono group were significantly lower than those in the normal dose group,and the subjective score was the lowest,with statistical differences(P<0.05).Conclusion In the case of reducing the contrast agent dose by 20%,the dual-energy CT reconstruction fusion method can not only reduce the damage of contrast agent

关 键 词：双能CT 肝脏增强 对比剂 体表面积 

分 类 号：R445.3[医药卫生—影像医学与核医学]