双低剂量CT能谱成像联合自适应统计迭代重建对甲状腺结节定性诊断价值  

The value of qualitative diagnosis in thyroid nodule evaluated by dual-low-dose CT energy spectral imaging combined with adaptive statistical iterative reconstruction-Veo

作　　者：郝爱华 丰川[1] 钱易 钱伟峰[2] 张继斌[1] 王宏[1] HAO Aihua;FENG Chuan;QIAN Yi;QIAN Weifeng;ZHANG Jibin;WANG Hong(Department of Radiology,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu Province 215002,China;Department of Thyroid and Breast Surgery,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu Province 215002,China)

机构地区：[1]南京医科大学附属苏州医院放射科,江苏苏州215002 [2]南京医科大学附属苏州医院甲乳外科,江苏苏州215002

出　　处：《实用放射学杂志》2025年第1期27-31,共5页Journal of Practical Radiology

摘　　要：目的探讨双低剂量CT能谱成像联合自适应统计迭代重建(ASIR-V)对甲状腺良恶性结节鉴别诊断价值。方法纳入242例甲状腺结节患者。第1部分:将前90例患者随机平均分为常规扫描组、低辐射剂量组、双低剂量组,评价3组主客观图像质量及辐射剂量、对比剂用量;第2部分:剩余152例患者行双低剂量CT能谱扫描,观察良、恶性组甲状腺结节的影像特征并进行能谱成像分析,测量并比较良恶性结节碘浓度(IC)值、标准化碘浓度(NIC)值、有效原子序数(Eff-Z)、能谱曲线斜率(λHU)值。结果甲状腺良恶性结节在结节形态、边缘截断征、强化特点及边界强化方面差异有统计学意义(P<0.05);静脉期IC值、NIC值及λHU值差异有统计学意义(P<0.05),IC、NIC、λHU的敏感度、特异度分别为81.6%、60.0%,86.4%、67.5%,88.8%、65.0%;3种能谱参数联合影像特征二元logistic回归分析模型的曲线下面积(AUC)为0.905,敏感度及特异度分别为82.4%、87.5%;双低剂量组有效剂量(ED)较常规扫描组减少60.13%,对比剂用量减少38.56%。结论双低剂量CT能谱成像联合ASIR-V大幅降低了辐射剂量和对比剂用量,同时有助于鉴别甲状腺良恶性结节,具有较大临床应用价值。Objective To explore the diagnostic value of dual-low-dose CT energy spectral imaging combined with adaptive statistical iterative reconstruction-Veo(ASIR-V)in distinguishing benign and malignant thyroid nodules.Methods A total of 242 patients with thyroid nodules were included.In partⅠ,the initial 90 patients were randomly and equally assigned to the conventional scan group,the low radiation dose group,and the dual-low-dose group.Both subjective and objective image qualities,the radiation dose,and contrast agent dosage in these three groups were evaluated,respectively.In partⅡ,the remaining 152 patients underwent duallow-dose CT energy spectral scanning.Radiographic features of thyroid nodules in benign and malinant groups were observed,followed by spectral imaging analysis.The iodine concentration(IC)value,normalized iodine concentration(NIC)value,effective atomic number(Eff-Z),andλHU value of benign and malignant nodules were measured and compared,respectively.Results There were significant differences in nodule morphology,sign of edge truncation,enhancement characteristics and nodule boundary enhancement between benign and malignant thyroid nodules(P<0.05).There were statistically significant differences in IC value,NIC value,andλHU value in the venous phase among the three groups(P<0.05).The sensitivity and specificity of IC,NIC,λHU were 81.6%and 60.0%,86.4%and 67.5%,88.8%and 65.0%,respectively.The area under the curve(AUC)of combining the three energy spectral parameters with radiographic features via binary logistic regression model was 0.905,and the sensitivity and specificity were 82.4%and 87.5%,respectively.The effective dose(ED)in the dual-low-dose group was reduced by 60.13%compared to the conventional scan group,and the contrast agent dosage was reduced by 38.56%.Conclusion The dual-low-dose CT energy spectral imaging combined with ASIR-V significantly reduced the radiation dose and the contrast agent dosage,and might help in distinguishing between benign and malignant thyroid nodules,demonstr

关 键 词：甲状腺结节 CT能谱成像 辐射剂量 对比剂 自适应统计迭代重建 

分 类 号：R581[医药卫生—内分泌] R814.42[医药卫生—内科学] R445.2[医药卫生—临床医学]