双能量CT虚拟平扫在肺结核CT诊断中的价值  

Value of dual-energy virtual plain scan in CT diagnosis of pulmonary tuberculosis

作　　者：丁晨宇 蒋东 秦立新 李宝学 李政旻 DING Chen-yu;JIANG Dong;QIN Li-xin;LI Bao-xue;LI Zheng-min(Department of Radiology,Wuhan Pulmonary Hospital,Wuhan 430033,Hubei,China)

机构地区：[1]武汉市肺科医院放射科,湖北武汉430033

出　　处：《生物医学工程与临床》2024年第6期811-816,共6页Biomedical Engineering and Clinical Medicine

基　　金：武汉市卫生健康委员会医学科研基金项目(WX21C08)。

摘　　要：目的探讨双能量CT虚拟平扫(VNC)技术在肺结核检查中替代CT常规平扫(TNC)的可行性。方法选择2023年3月至9月在武汉市肺科医院完成胸部CT TNC和双能量CT VNC的肺结核患者60例,其中男性34例,女性26例;年龄18~72岁,平均年龄40.12岁;病程3~26个月,平均病程15.21个月;结核菌痰检阳性。两组患者均接受胸部CT TNC和双能量CT VNC。两种检查方式完成后,对其CT图像质量和辐射剂量及对肺结核病变检出率进行评价。结果CT TNC与CT VNC图像主动脉噪声和信噪比(SNR)比较,差异有统计学意义[(8.99±3.04)Hu vs(10.37±2.42)Hu、4.97(3.57~6.99)vs 4.05(3.20~4.83)。P<0.05],主动脉CT值、肌肉CT值和竖脊肌噪声差异无统计学意义(P>0.05);两种检查方式CT图像医师主观评价比较,差异无统计学意义(P>0.05)。两种检查方式图像医师评分均为3分及以上,图像均满足诊断标准。两种检查方式图像病变检出率比较,差异无统计学意义(P>0.05);CT TNC与CT VNC动脉期辐射剂量差异无统计学意义(P>0.05);两种检查方式图像实际剂量(ED)值相近,只相差0.06 mSv。结论双能量CT VNC对肺结核病变的检出能力和图像质量与CT TNC相仿,能避免患者接受更多的辐射剂量。Objective To explore the feasibility of dual-energy CT virtual non-contrast(VNC)technique to replace conventional CT true non-contrast(TNC)in pulmonary tuberculosis examination.Methods From March to September 2023,a total of 60 patients with pulmonary tuberculosis underwent chest CT plain scan and dual-energy enhanced scan were enrolled,which included 34 males and 26 females,aged 18-72 years old with mean age of 40.12 years old;disease course was 3-26 months with mean course of 15.21 months.The sputum examination of tuberculosis was positive.All of them performed chest CT plain scan and dual-energy enhanced scan.After completion of 2 methods,the image quality and radiation dose of conventional plain CT and dual-energy virtual plain CT and detection rate of pulmonary tuberculosis lesions were evaluated.Results There were significant differences in aortic noise and signal-to-noise ratio(SNR)between TNC and VNC CT images[(8.99±3.04)Hu vs(10.37±2.42)Hu,4.97(3.57~6.99)vs 4.05(3.20~4.83).P<0.05],there was no significant difference in aortic CT value,muscle CT value and erector spinae noise between 2 methods(P>0.05).There was no significant difference in the subjective evaluation of CT images between 2 methods(P>0.05).The physician scores of 2 methods were 3 and above,and all the images met diagnostic criteria.There was no significant difference in detection rate of image lesions between 2 methods(P>0.05);there was no significant difference in radiation dose between conventional plain scan and dual energy arterial phase(P>0.05);the effective dose(ED)values of 2 methods were similar,with difference of 0.06 mSv.Conclusion It is demonstrated that the detection ability and image quality of dual-energy VNC for pulmonary tuberculosis lesions are similar to TNC,which could avoid patients receiving additional radiation dose.

关 键 词：CT 虚拟平扫 双能量 肺结核 常规平扫 

分 类 号：R521[医药卫生—内科学] R816.41[医药卫生—临床医学]