门脉期能谱CT技术对提高肝硬化门静脉成像质量的研究

发布时间：2018-11-25 11:38

【摘要】：目的:探讨能谱CT技术对提高肝硬化患者门静脉成像质量的应用价值。方法 :对临床明确有肝硬化病史的42例患者行上腹部CT增强扫描,平扫、动脉期采用常规螺旋扫描,门静脉期使用能谱扫描模式获得门静脉期最佳对比信噪比(CNR)单能图像和传统混合能量图像(QC图像),并行门静脉容积再现(VR)和最大密度投影(MIP)重组。测量两组图像中门静脉和肝实质的CT值、图像噪声,用肝实质作为对照测量门脉主干的CNR,并由两名具有10年以上腹部影像诊断经验的医师在盲法条件下对2组重建图像进行主观图像质量评分。两组间比较采用两独立样本t检验,两名医师对重建图像质量一致性评估采用Kappa检验。结果:门静脉最佳CNR单能图像能量水平集中在50~53 ke V左右。最佳CNR单能图像上门静脉和肝实质的CT值、图像噪声和门静脉-肝实质的CNR(分别为(300.82±33.07)HU,(147.53±22.65)HU,26.48±3.87,5.87±1.35)均高于QC图像(分别为(150.05±27.36)HU,(98.96±16.33)HU,16.78±3.10,3.06±0.99),两者间差异有统计学意义(P0.01)。两名医师对最佳CNR单能重建图像质量评价一致性(Kappa值为0.759)高于QC重建图像(Kappa值为0.521);两组图像质量评分分别为(4.17±0.72)分和(3.06±0.55)分,差异有统计学意义(P0.01)。结论 :能谱CT最佳CNR单能量图像能明显提高肝硬化门静脉与肝实质的CNR,使门静脉及其分支的图像质量显著提高。
[Abstract]:Objective: to evaluate the value of energy dispersive CT in improving the quality of portal vein imaging in patients with liver cirrhosis. Methods: 42 patients with definite history of cirrhosis were examined by CT enhanced scan, plain scan and routine spiral scan in arterial phase. The best contrast signal-to-noise ratio (SNR) (CNR) monoenergy image and traditional mixed energy image (QC image) were obtained from portal vein phase by energy spectrum scanning mode. (VR) and maximum density projection (MIP) recombination were performed in portal vein phase. The CT value of portal vein and hepatic parenchyma, image noise, and CNR, of portal vein trunk were measured with hepatic parenchyma as control. Two physicians with more than 10 years experience in abdominal imaging diagnosis were evaluated with subjective image quality in two groups of reconstructed images under the condition of blind method. Two independent samples t test were used in the comparison between the two groups, and two physicians used Kappa test to evaluate the consistency of reconstruction image quality. Results: the energy level of the best CNR images of portal vein was about 50 ~ 53 ke V. The CT value of portal vein and hepatic parenchyma, image noise and CNR of portal vein and hepatic parenchyma on optimal CNR monoenergetic images were (300.82 卤33.07) HU, (147.53 卤22.65) HU, respectively. 26.48 卤3.87 卤1.35 was significantly higher than that of QC (150.05 卤27.36) HU, (98.96 卤16.33) HU,16.78 卤3.10 卤3.06 卤0.99, the difference was statistically significant (P0.01). The consistency of two physicians in evaluating the image quality of the best CNR monotropic reconstruction image (Kappa value was 0.759) was higher than that of QC reconstruction image (Kappa value was 0.521). The image quality scores of the two groups were (4.17 卤0.72) and (3.06 卤0.55), respectively. The difference was statistically significant (P0.01). Conclusion: the best CNR single energy image of energy spectrum CT can significantly improve the quality of portal vein and its branches in cirrhotic patients with portal vein and hepatic parenchyma CNR,.
【作者单位】：广西医科大学第三附属医院南宁市第二人民医院放射科;
【分类号】：R575.2;R816.5

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