双源CT虚拟平扫在小肠病变中的应用

发布时间：2018-05-02 03:59

本文选题：肠疾病 + 体层摄影术　；参考：《中国临床医学影像杂志》2017年04期

【摘要】：目的:探讨双源CT虚拟平扫在小肠病变中的应用。方法:对35位患者在双源CT上行小肠造影检查,共三期扫描,即常规平扫、动脉期和静脉期对比增强双能量扫描(100 k V/140 k V),调入后处理软件中的Liver VNC选项卡,获得动、静脉期虚拟平扫图像,将其与真实平扫图像进行对比。对图像质量进行主观评分以及客观评分,主观评分由2名医生采用双盲法评分,客观评分在3个序列的图像上选择感兴趣区,分别记录下动、静脉期虚拟平扫及真实平扫的病灶、肝脏、肌肉、脂肪的平均CT值,以及由机器产生的噪声,病灶的信噪比(SNR)及对比信噪比(CNR)。同时记录下三期扫描的总辐射剂量及去除平扫剂量之后动、静脉增强两期扫描的总辐射剂量。采用单因素方差分析比较两组以上图像平均CT值、SNR、CNR。采用两个独立样本t检验分析辐射剂量。结果:35例患者,其中男16例,女19例,年龄27~83岁,未见明显异常16例,慢性结肠炎3例,粘连性肠梗阻4例,肿瘤切除术后2例,肠息肉3例,脂肪瘤2例,结肠恶性肿瘤3例,肠系膜纤维瘤1例,回盲部肿物1例。采用SPSS 21.0软件进行统计分析,病灶、脂肪、肌肉虚拟平扫的CT值小于真实平扫,差异有统计学意义,而肝脏虚拟平扫的CT值大于真实平扫,差异有统计学意义。虚拟平扫的标准差低于真实平扫,而SNR、CNR高于真实平扫,差异无统计学意义。3种图像主观评分均能满足诊断要求,虽然虚拟平扫的主观评分要低于真实平扫,但是其差异无统计学意义,优质图像率达71.8%。双能两期扫描辐射剂量低于常规三期扫描的24.8%。结论:在患者小肠造影的检查中,双能CT的虚拟平扫图像可以用作基准的密度测量及传统平扫的替代,省去常规增强前扫描,大大降低患者接受的辐射剂量。
[Abstract]:Objective: to explore the application of double source CT virtual plain scan in small intestinal lesions. Methods: 35 patients were examined by double source CT uplink enterography, including routine plain scan, arterial phase and venous phase contrast enhanced dual energy scan (100kV / 140k V), and Liver VNC tab in post-processing software. Venous phase virtual plain scan images were compared with real plain scan images. Subjective score and objective score were used to evaluate the image quality. The subjective score was scored by two doctors with double blind method. The objective score was selected on the image of three sequences and recorded separately. The mean CT values of the focus, liver, muscle and fat, the noise produced by the machine, the SNR of the lesion and the contrast signal-to-noise ratio (CNR) of the virtual plain scan and the real plain scan in venous phase. At the same time, the total radiation dose of three phase scanning and the total radiation dose after removing the plain scan dose and vein enhancement were recorded. Single factor analysis of variance (ANOVA) was used to compare the average CT value of more than two groups. Two independent samples were used to analyze the radiation dose. Results among 35 patients, 16 were male, 19 were female, the age was 2783 years old. There were no obvious abnormality in 16 cases, chronic colitis in 3 cases, adhesive intestinal obstruction in 4 cases, tumor resection in 2 cases, intestinal polyp in 3 cases, lipoma in 2 cases. There were 3 cases of colon malignant tumor, 1 case of mesenteric fibroma and 1 case of ileocecal tumor. The CT value of virtual plain scan of focus, fat and muscle was lower than that of real plain scan, the difference was statistically significant, while the CT value of virtual plain scan of liver was larger than that of real plain scan, and the difference was statistically significant. The standard deviation of virtual plain scan is lower than that of real plain scan, while SNRN CNR is higher than that of real plain scan. There is no statistical significance between the subjective scores of virtual plain scan and real plain scan. The subjective score of virtual plain scan is lower than that of real plain scan, although the subjective score of virtual plain scan is lower than that of real plain scan. But its difference has no statistical significance, the high quality image rate reaches 71.8%. The radiation dose of dual energy two phase scan was lower than that of routine 3 phase scan 24. 8%. Conclusion: the virtual plain scan of dual energy CT can be used as the standard density measurement and the replacement of conventional plain scan in the examination of small intestine.
【作者单位】：新疆维吾尔自治区人民医院放射影像中心;
【基金】：新疆自然科学基金(2015211C189)
【分类号】：R574.5;R816.5

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