个体化碘流率注射对比剂方案用于结直肠癌能谱CT增强扫描  

Injection protocol of contrast agents based on individualized iodine delivery rate applicated in enhanced spectral CT scanning of colorectal cancer

作　　者：张竞颐 刘磊[2] 刘义军[1] 王诗耕 魏巍 马志明 ZHANG Jingyi;LIU Lei;LIU Yijun;WANG Shigeng;WEI Wei;MA Zhiming(Department of Radiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Department of Urology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院放射科,辽宁大连116011 [2]大连医科大学附属第一医院泌尿外科,辽宁大连116011

出　　处：《中国介入影像与治疗学》2025年第4期279-283,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察个体化碘流率(IDR)注射对比剂方案用于结直肠癌能谱CT增强扫描的价值。方法前瞻性纳入131例结直肠癌并随机将其分为常规组(A组64例,以常规方法注射对比剂)与个体化组(B组67例,基于个体化IDR注射对比剂)。行全腹能谱CT增强扫描,于A组重建动、静脉期70keV图像(A组70kev),对B组重建动、静脉期40~70keV(间隔10keV)图像(B组40~70kev),2组均重建碘基图。对增强CT图像质量进行主、客观评价,计算病灶标准化碘浓度(NIC)并进行组间比较。结果B组碘摄入量低于A组(P<0.001)。动、静脉期B组60kev主观评分均最高,且与A组70kev差异均无统计学意义(P均>0.05)。B组40~60kev动脉期图像中的肠系膜上动脉(SMA)及腹主动脉的CT值、信噪比(SNR)和对比度噪声比(CNR)均高于A组z0kev动脉期图像(P均<0.05);B组40~50kev静脉期图像中的肠系膜上静脉(SMV)的CT值、SNR和CNR,以及B组60kev静脉期图像中SMV的CT值和CNR均高于A组70kev静脉期图像(P均<0.05);而组间病灶动、静脉期NIC差异均无统计学意义(P均>0.05)。结论个体化IDR注射对比剂方案结合60keV单能量图像用于结直肠癌能谱CT增强扫描可在不影响图像质量的前提下降低对比剂用量。Objective To explore the value of contrast agent injection protocol based on individualized iodine delivery rate(IDR)applicated in enhanced spectral CT scanning of colorectal cancer.Methods Totally 131 colorectal cancer patients were prospectively collected and randomly divided into conventional group(group A,n=64,contrast agents were injected with routine method)and individualized group(group B,n=67,contrast agents were injected with individualized IDR method).Whole abdominal energy spectrum CT scanning was performed,and 70 keV images at arterial and venous phases(Azo kev)of group A and 40-70 keV images(interval 10 keV)at arterial and venous phases(Bao-70 kev)of group B were reconstructed,and iodine-based material maps were reconstructed.Subjective and objective evaluation on quality of enhanced images were performed,lesions'normalized iodine concentration(NIC)were calculated,and the above indexes were compared between groups.Results Iodine intake in group B was lower than that in group A(P<0.001).The subjective scores of Bokev images at both arterial and venous phases were the highest,which were not different from those of Azokey images(both P>0.05).CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)ofsuperior mesenteric artery(SMA)and abdominal aortaonarterial Bao-60 kev images were higher than those in arterial Azo kev images(all P<0.05).CT values,SNR and CNR of superior mesenteric vein(SMV)on venous Bao-50 kev,as well as CT values and CNR of SMV on venous Bokev images were all higher than those on venous Azo kev images(all P<0.05).No significant difference of lesions'NIC in arterial and venous phases was detected between groups(both P>0.05).Conclusion Injection of contrast agents based on IDR combined with 60 keV single energy image for enhanced energy spectrum CT scanning of colorectal cancer could reduce the amount of contrast agents while do not affect imaging quality.

关 键 词：结直肠肿瘤 体层摄影术 X线计算机 对比剂 碘流率 前瞻性研究 

分 类 号：R735.37[医药卫生—肿瘤] R814.42[医药卫生—临床医学]