低剂量双源CT扫描在腹部三期增强检查中的应用效果

张紫瑞; 盛美红; 李飞

doi:10.11659/jjssx.09E022107

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低剂量双源CT扫描在腹部三期增强检查中的应用效果

临床研究 | 更新时间：2023-05-26

- 低剂量双源CT扫描在腹部三期增强检查中的应用效果
- Application effect of low-dose dual-source CT scan in abdominal three-phase enhanced examination
- 局解手术学杂志 2023年32卷第5期页码：400-403
- 作者机构：
  
  南通大学第二附属医院影像科，江苏南通 226001
- 作者简介：
  
  张紫瑞，E-mail：ku95285@163.com
- 基金信息：
  
  国家自然科学基金(81702216)
- DOI：10.11659/jjssx.09E022107
  中图分类号： R735.7;R445.3
- 纸质出版日期：2023-05-25，
  
  收稿日期：2022-09-20，
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张紫瑞,盛美红,李飞.低剂量双源CT扫描在腹部三期增强检查中的应用效果[J].局解手术学杂志,2023,32(05):400-403.

ZHANG Zi-rui,SHENG Mei-hong,LI Fei.Application effect of low-dose dual-source CT scan in abdominal three-phase enhanced examination[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):400-403.
张紫瑞,盛美红,李飞.低剂量双源CT扫描在腹部三期增强检查中的应用效果[J].局解手术学杂志,2023,32(05):400-403. DOI： 10.11659/jjssx.09E022107.

ZHANG Zi-rui,SHENG Mei-hong,LI Fei.Application effect of low-dose dual-source CT scan in abdominal three-phase enhanced examination[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(05):400-403. DOI： 10.11659/jjssx.09E022107.

摘要

目的

探讨低剂量双源CT扫描在腹部三期增强检查中的应用效果。

方法

回顾性分析我院140例疑似肝癌患者的临床资料，患者均行双源CT腹部三期增强检查，根据增强扫描中能量和碘海醇剂量的不同将其分为A1组（低能量低剂量，80 keV、270 mgI/mL）37例、A2组（低能量高剂量，80 keV、350 mgI/mL）35例、B1（高能量低剂量，140 keV、270 mgI/mL）40例、B2组（高能量高剂量，140 keV、350 mgI/mL）28例。采用图像质量主观评分和客观评分[信噪比（SNR）]评估各组图像质量，计算各组图像的有效照射剂量[剂量长度乘积（DLP）及有效剂量（ED）]。以病理检查结果为金标准，评估低剂量双源CT腹部三期增强扫描诊断肝癌的价值。

结果

各组图像可清晰显示血管及脏器组织，均达到诊断要求。各组在动脉期和门静脉期的图像质量主观评分比较差异无统计学意义（

0.05）。各组动脉期和门静脉期腹主动脉腹腔干、腹腔动脉干、肠系膜上动脉、门静脉主干图像SNR比较，差异具有统计学意义（

0.05），且A1组所得图像SNR明显高于其他组（

0.05）。各组腹部增强扫描的DLP及ED比较差异具有统计学意义（

0.05），且A1组DLP及ED明显低于其他组（

0.05）。140例疑似肝癌患者经病理确诊为肝癌79例，低剂量双源CT腹部三期增强扫描诊断出75例，诊断的敏感度、特异度和准确度分别为86.07%、91.80%和88.57%，

Kappa

值为0.769。

结论

低剂量双源CT腹部三期增强扫描在80 keV的低能量行单能量重建获得的图像质量最佳，具有较高的敏感度、特异度及准确度，可满足影像诊断的要求，安全性高。

Abstract

Objective

To explore the application effect of low-dose dual-source CT scan in abdominal three-phase enhanced examination.

Methods

A retrospective analysis was performed on the clinical data of 140 patients with suspected liver cancer in our hospital.All patients underwent dual-source CT scan abdominal three-phase enhanced examination

and 37 cases were included into the group A1 (with low energy of 80 keV and low dose of 270 mgI/mL)

35 cases were included into the group A2 (with low energy of 80 keV and high dose of 350 mgI/mL)

40 cases were included into the group B1 (with high energy of 140 keV and low dose of 270 mgI/mL) and 28 cases were included into the group B2 (with high energy of 140 keV and high dose of 350 mgI/mL) according to energy and iohexol dose in enhanced scan.The image quality of each group was evaluated by subjective score and objective score with signal-to-noise ratio (SNR).The effective radiation doses including dose length product (DLP) and effective dose (ED) in each group were calculated.The value of low-dose dual-source CT scan abdominal three-phase enhanced examination in the diagnosis of liver cancer was evaluated by taking pathological examination results as the gold standard.

Results

The images of each group could clearly show blood vessels and tissues of organs

which met the diagnostic requirements.There was no significant difference in the subjective scores of image quality in the arterial phase or portal vein phase among groups (

0.05).There were significant differences in SNR of images in abdominal aorta celiac trunk

celiac artery trunk

superior mesenteric artery and main trunk of portal vein at arterial phase and portal vein phase among groups (

0.05)

and SNR of images in group A1 was significantly higher than that in other groups (

0.05).There were significant differences in DLP and ED during abdominal enhanced scan among groups (

0.05)

and DLP and ED of group A1 were significantly lower than those of other groups (

0.05).Among the 140 patients with suspected liver cancer

79 cases were diagnosed as liver cancer by the pathological examination and 75 cases were diagnosed by low-dose dual-source CT scan abdominal three-phase enhanced examination with the sensitivity of 86.07%

specificity of 91.80%

accuracy of 88.57% and

Kappa

value of 0.769.

Conclusion

Low-dose dual-source CT abdominal three-phase enhanced scan with single energy reconstruction at a low energy of 80 keV has the best image quality

which can meet the requirements of imaging diagnosis

with high sensitivity

specificity and accuracy as well as high security.

关键词

双源CT低剂量扫描腹部三期增强检查图像质量

Keywords

dual-source CTlow-dose scanabdominal three-phase enhanced examinationimage quality

references

Ruth V，Kolditz D，Steiding C，et al.Investigation of spectral performance for single-scan contrast-enhanced breast CT using photon-counting technology：a phantom study［J］.Med Phys，2020，47（7）：2826-2837.doi：10.1002/mp.14133http://dx.doi.org/10.1002/mp.14133.

戚元刚，李向华，李云.动态增强CT在腹腔间质瘤和神经内分泌瘤鉴别诊断中的应用价值［J］.临床放射学杂志，2020，39（2）：120-123.doi：10.13437/j.cnki.jcr.2020.02.027http://dx.doi.org/10.13437/j.cnki.jcr.2020.02.027.

Kim SH.Doppler US and CT diagnosis of nutcracker syndrome［J］.Korean J Radiol，2019，20（12）：1627-1637.doi：10.3348/kjr. 2019.0084http://dx.doi.org/10.3348/kjr.2019.0084.

周文华，徐大伟，王立军，等.多层螺旋CT及动态增强磁共振成像血流参数在肝良恶性结节鉴别诊断中应用价值探究［J］.中华生物医学工程杂志，2019，25（5）：518-522.doi：10.3760/cma.j.issn.1674-1927.2019.05.002http://dx.doi.org/10.3760/cma.j.issn.1674-1927.2019.05.002.

代召刚，刘斌，周勇.双源CT双能量成像技术在肾结石定性分析中的应用价值［J］.中国医学计算机成像杂志，2019，25（4）：363-368.doi：10.3969/j.issn.1006-5741.2019.04.008http://dx.doi.org/10.3969/j.issn.1006-5741.2019.04.008.

苗娜，林方才，齐旭红，等.双源CT能谱纯化对肺及乳腺联合筛查的低剂量研究［J］.现代肿瘤医学，2019，27（14）：2561-2564.doi：10.3969/j.issn.1672-4992.2019.14.032http://dx.doi.org/10.3969/j.issn.1672-4992.2019.14.032.

Schmidt B，Flohr T.Principles and applications of dual source CT［J］.Phys Med，2020，7（9）：36-46.doi：10.1016/j.ejmp.2020.10.014http://dx.doi.org/10.1016/j.ejmp.2020.10.014.

刘海静，夏远舰，申兵，等.64排螺旋CT和双源CT在肝硬化门静脉高压侧支循环中的应用研究［J］.河北医药，2019，41（10）：1518-1520.doi：10.3969/j.issn.1002-7386.2019.10.018http://dx.doi.org/10.3969/j.issn.1002-7386.2019.10.018.

郭油油，李咏梅，王静杰，等.双源CT能谱参数定性诊断甲状腺乳头状癌术后颈部转移淋巴结［J］.中国医学影像技术，2019，35（5）：669-672.doi：10.13929/j.1003-3289.201808147http://dx.doi.org/10.13929/j.1003-3289.201808147.

郑海茹，林海锋，徐军女，等.三期增强CT扫描联合GP73，AFP及AFP-L3检测对原发性肝癌的诊断效能研究［J］.中国CT和MRI杂志，2022，20（4）：99-101.doi：10.3969/j.issn.1672-5131.2022.04.032http://dx.doi.org/10.3969/j.issn.1672-5131.2022.04.032.

Kim TY，Lee Y.Contrast-enhanced multi-detector CT examination of parotid gland tumors：determination of the most helpful scanning delay for predicting histologic subtypes［J］.J Belg Soc Radiol，2019，3（1）：20-21.doi：10.5334/jbsr.1596http://dx.doi.org/10.5334/jbsr.1596.

Pulickal GG，Singh D，Lohan R，et al.Dual-source dual-energy CT in submandibular sialolithiasis：reliability and radiation burden［J］.AJR Am J Roentgenol，2019，213（6）：1291-1296.doi：10.2214/AJR. 19.21299http://dx.doi.org/10.2214/AJR.19.21299.

Li Z，Zhang L，Liu X，et al.Diagnostic utility of CT for small bowel obstruction：systematic review and meta-analysis［J］.PLoS One，2019，14（12）：e0226740.doi：10.1371/journal.pone.0226740http://dx.doi.org/10.1371/journal.pone.0226740.

徐吉雄，陈宏伟，方向明，等.双源CT冠状动脉CTA诊断老年冠心病合并肺部感染的应用价值分析［J］.中西医结合心脑血管病杂志，2020，18（14）：2302-2305.doi：10.12102/j.issn.1672-1349.2020.14.027http://dx.doi.org/10.12102/j.issn.1672-1349.2020.14.027.

Petritsch B，Pannenbecker P，Weng AM，et al.Comparison of dual-and single-source dual-energy CT for diagnosis of acute pulmonary artery embolism［J］.Rofo，2021，193（4）：427-436.doi：10.1055/a-1245-0035http://dx.doi.org/10.1055/a-1245-0035.

Tao A，Huang R，Tao S，et al.Dual-source photon counting detector CT with a tin filter：a phantom study on iodine quantification performance［J］.Phys Med Biol，2019，64（11）：115-116.doi：10.1088/1361-6560/ab1c34http://dx.doi.org/10.1088/1361-6560/ab1c34.

Zeng D，Yao L，Ge Y，et al.Full-spectrum-knowledge-aware tensor model for energy-resolved CT iterative reconstruction［J］.IEEE Trans Med Imaging，2020，39（9）：2831-2843.doi：10.1109/TMI.2020.2976692http://dx.doi.org/10.1109/TMI.2020.2976692.

Alikhani B，Werner M，Jamali L，et al.Image quality performance of virtual single-source CT using dual-source computed tomography［J］.Acad Radiol，2019，26（8）：1095-1101.doi：10.1016/j.acra.2018.09.021http://dx.doi.org/10.1016/j.acra.2018.09.021.

徐永平，张玄星，陈伟彬.能谱CT单能量技术联合低对比剂，低流速对腹主动脉的优化扫描［J］.中国煤炭工业医学杂志，2020，23（6）：113-118.doi：10.11723/mtgyyx1007-9564202006001http://dx.doi.org/10.11723/mtgyyx1007-9564202006001.

Nakhostin D，Sartoretti T，Eberhard M，et al.Low-dose dual-energy CT for stone characterization：a systematic comparison of two generations of split-filter single-source and dual-source dual-energy CT［J］.Abdom Radiol （NY），2021，46（5）：2079-2089.doi：10.1007/s00261-020-02852-5http://dx.doi.org/10.1007/s00261-020-02852-5.

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