能谱探测器CT在上腔静脉CT成像中的应用

发布时间：2018-12-23 13:23

【摘要】：目的评估新一代能谱探测器CT在上腔静脉(SVC)CT成像中的应用价值。方法连续纳入30例患者,均接受胸部增强CT扫描,所有扫描图像重建为8个序列,包括120 k Vp常规扫描成像及40、50、60、70、80、90、100 ke V能级的能谱图像。在各组SVC管腔近、中、远段勾画感兴趣区,测量各个感兴趣区及前胸壁均匀脂肪组织的CT值和标准差值,计算图像信噪比(SNR)、对比噪声比(CNR)和每例患者所接受的有效剂量(ED)。由2名医师采用双盲法共同对图像质量进行主观评分。组间图像质量比较采用独立样本t检验,2名医师对图像质量的主观评分采用非参数检验,并计算Kappa(κ)值评价2名医师对图像质量分析的一致性。结果各个能级水平SVC管腔近、中、远段CT值差异均无统计学意义(P均0.05)。单能谱40 ke V时SVC管腔平均CT值为(223.51±40.35)HU,SNR为13.56±4.18,CNR为24.15±6.58,明显高于其他各能级组和常规扫描组[CT值:(97.70±13.85)HU;SNR:4.59±1.41;CNR:9.69±2.81](P0.005)。所有患者所接受的平均ED为(2.04±0.63)m Sv。两位医师对图像质量的评分分别为1(1,2)、1(1,2),差异无统计学意义(Z=-0.358,P=0.720)。两位医师对图像质量的主观评价具有非常好的一致性(κ=0.863,P=0.000)。结论应用能谱探测器CT可以良好地显示SVC,且显影最佳的单能谱能级是40 ke V。
[Abstract]:Objective to evaluate the application value of new generation energy spectrum detector (CT) in superior vena cava (SVC) CT imaging. Methods Thirty consecutive patients were examined by chest enhanced CT. All the images were reconstructed into 8 sequences, including 120k Vp conventional scanning and energy spectrum images of 80,90100 ke V energy levels. The region of interest was delineated in the proximal, middle and distal segments of the SVC lumen in each group. The CT value and standard difference of the homogeneous adipose tissue in each region of interest and the anterior chest wall were measured, and the SNR (SNR), of the image was calculated. Contrast noise ratio (CNR) and effective dose of (ED). For each patient The image quality was evaluated by two doctors using double blind method. The independent sample t test was used to compare the image quality among the two groups, the non-parametric test was used to evaluate the subjective score of the two physicians, and the Kappa (魏) value was calculated to evaluate the consistency of the image quality analysis between the two physicians. Results there was no significant difference in CT values between the SVC lumen and the middle and distal segments of each level (P < 0. 05). The average CT value of SVC lumen at 40 ke V was (223.51 卤40.35) HU,SNR (24.15 卤6.58), which was significantly higher than that in other energy levels and conventional scanning groups [(97.70 卤13.85) HU;SNR:4.59 卤1.41]. CNR:9.69 卤2.81] (P0.005). The average ED accepted by all patients was (2.04 卤0.63) m Sv.) The image quality scores of the two doctors were 1 (1 / 2) and 1 (1 / 2), respectively. The subjective evaluation of image quality by the two physicians was very consistent (魏 = 0.863P0. 000). Conclusion CT can display SVC, well and the best single energy level is 40 ke V.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;
【基金】：国家临床重点专科建设项目(2014)~~
【分类号】：R816.2

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