双层探测器光谱CT单能级对肝硬化患者门静脉血管成像的可行性研究  

Feasibility Study of Double-layer Detector Spectral CT Single-energy Level for Portal Vein Vascular Imaging in Patients with Cirrhosis

作　　者：张婷婷[1,2] 刘雪 张道恩 周林 夏春潮 ZHANG Ting-ting;LIU Xue;ZHANG Dao-en;ZHOU Lin;XIA Chun-chao(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Department of Radiology,The Third Affiliated Hospital of Chengdu Medical College,Chengdu Pidu District People's Hospital,Chengdu 610041,Sichuan Province,China;Department of Radiology,Nyingchi People's Hospital,Nyingchi 860100,Tibet,China;Department of Medical Imaging,The Second Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China)

机构地区：[1]四川大学华西医院放射科,四川成都610041 [2]成都医学院第三附属医院·成都市郫都区人民医院放射科,四川成都610041 [3]西藏林芝市人民医院放射科,西藏林芝860100 [4]遵义医科大学第二附属医院影像科,贵州遵义563000

出　　处：《中国CT和MRI杂志》2024年第12期95-97,共3页Chinese Journal of CT and MRI

基　　金：四川省医学会(恒瑞)科研基金专项科研课题(2021HR68)。

摘　　要：目的利用双层探测器光谱CT对肝硬化患者行常规上腹部血管成像,探讨其单能级(40keV)对门静脉血管成像的图像质量及其临床应用价值。方法回顾性分析四川大学华西医院2023年1月-2023年7月临床确诊为肝硬化且利用双层探测器光谱CT行常规上腹部血管成像的30例患者的影像资料,利用IntelliSpace Portal软件对门脉期图像重建获得120KVp混合能量图像和(40、55、70keV)的单能级图像。测量4组门静脉图像的噪声(SD)、信噪比(SNR)和对比噪声比(CNR),由两位医生对图像整体质量进行评分评价。结果40keV组门静脉的CT值,SNR和CNR及图像质量主观评分均高于其余组,差异有统计学意义(P<0.01),40keV组的门静脉噪声(24.94±8.54)均高于120KVp组(21.42±5.49)及其余VMI组。两位医师评分的一致性较好(kappa值为0.775、0.824)。结论肝硬化患者行双层探测器光谱CT常规上腹部血管成像,40keV时门静脉图像质量最佳,有助于门静脉疾病的诊断。Objective To investigate the image quality of virtual monoenergetic images(VMIs)of portal vein angiography and the clinical application value by using dual-layer detector spectral CT(DLCT)for routine upper abdominal angiography in cirrhotic patients.MethodsWe retrospectively analyzed 30 patients with liver cirrhosis who underwent routine upper abdominal angiography DLCT examination from January 2023 to July 2023.Conventional polyenergetic images(PEIs)and VMIs at 40–70 keV(VMI40,55,70,15-keV increments)were generated from portal venous phase(PVP).The noise,CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of PVP in four groups were measured,and the overall image quality was scored and evaluated by two radiologists.ResultsThe CT values(555.92±181.39),SNR(19.02±10.2)and CNR(28.01±15.24)of portal vein in VMI40 were higher than the other three groups.The difference was statistically significant(P<0.01).The portal vein noise in 40keV group(24.94±8.54)was higher than that in 120KVp group(21.42±5.49)and other VMI groups.The scores of the two physicians were consistent(kappa values were 0.775 and 0.824).The agreement of the scores of the two radiologists was good(kappa values of 0.775 and 0.824).ConclusionThe virtual monoenergetic 40 keV portal vein images showed the best images quality from conventional upper abdominal angiography with dual-layer detector spectral CT in cirrhotic patients,which can meet the clinical diagnostic requirements and be valuable in the diagnosis of portal vein disease.

关 键 词：双层探测器 CT 肝硬化 门静脉 

分 类 号：R657.31[医药卫生—外科学]