双源CT虚拟单能技术在支气管动脉血管成像中的应用研究

doi:10.12117/jccmi.2020.01.009

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摘要目的：采用双源CT单能及双能技术进行支气管动脉血管成像，并对比二者的图像质量及辐射剂量，探讨双源CT双能模式下的虚拟单能技术在支气管动脉成像中的临床意义。方法：收集我院2016年3月—2017年11月胸部CT增强病患64例，将其随机分成2组（单能组及双能组），每组32例。对比剂采用碘帕醇（370 mgI/mL），剂量为1.2 mL/kg，流速固定在4.0 m/s，追加生理盐水40 mL。单能组每个病患得到一组增强图像，双能组可生成40～190 keV多组图像，并通过虚拟单能技术自动得出对比度信噪比（Contrast-to-noise ratio，CNR）最高的一组图像，将得出的两组图像进行图像质量主观评分、支气管动脉CT值、噪声（Standard deviation，SD）、CNR、信噪比（Single-to-noise ratio，SNR）以及辐射剂量等参数进行对比。结果：两名放射科主任医师对支气管动脉主观评分结果呈优秀吻合（所有Kappa值>0.8）。与单能组相比，双能组右侧和左侧支气管动脉图像质量主观评分均明显更高（P<0.001，P=0.001）。除此之外，在双能组中，左右支气管动脉的CT值（P<0.001，P<0.001）、噪声（P<0.001，P<0.001）、CNR（P=0.001，P=0.003）、SNR（P=0.012，P=0.035）均显著高于单能组。辐射剂量方面，双能组与单能组的CTDI和DLP均无明显差异（P=0.097，P=0.132）。结论：双源CT双能模式下的虚拟单能量技术能够提高支气管动脉的血管成像质量，显示更细小的血管走形，更好的满足诊断需求。

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	胡纳
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	杨国庆
	付泉水

关键词 ：支气管动脉, 体层摄影术, X线计算机

Abstract：Objective: To study the virtual monoenergetic image quality and radiation dose of dual-energy mode with single-energy mode for bronchial artery in dual-source dual-energy CT. To explore the clinical significance of dual-source CT dual-energy virtual single-energy technology in bronchial artery imaging. Methods: Sixty-four patients were randomly dived into 2 groups: dual-energy group and single-energy group, 32 cases for each group. 1.2 mL/kg of iodine contrast medium (370 mgI/mL) for patients was injected via the antecubital vein at a rate of 4 mL/s, and 40 mL normal saline was added. One group of enhanced images was obtained for each patient in the single-energy group, and multiple groups of images ranging from 40 keV to 190 keV were generated in the dual-energy group, and the group with the highest contrast signal-to-noise ratio(CNR) was automatically obtained through virtual single-energy technology. A 5-point scale was carried out to evaluate angiography image quality by two radiologists subjectively. Mean CT attenuation value and standard deviation were measured to calculate the CNR and single-to-noise ratio(SNR). Volume computed tomography dose index(CTDI) and the dose-length product(DLP) for calculating radiation dose were recorded automatically. Subjective scores and quantitative parameters were compared via Mann-Whitney U test and T test respectively. Results: There were excellent agreements between two radiologists for grading right and left bronchial arteries respectively(all Kappa value>0.8). Image quality scores were significantly higher in dual-energy group compared with single-energy group for both right(P<0.001) and left(P=0.001) angiography branches. Compared with single-energy, dual-energy group demonstrated higher CT attenuation(P<0.001, P<0.001), standard deviation(P<0.001, P<0.001), CNR(P=0.001, P=0.003) and SNR(P=0.012, P=0.035) in right and left bronchial arteries respectively. There were no significant differences in two groups for CTDI and DLP respectively(P=0.097, P=0.132). Conclusion: Dual-energy bronchial artery CT angiography with virtual monochromatic technique has significant higher image quality which can better meet the need for diagnosis and preoperative evaluation.

Key words： Bronchial arteries Tomography, X-ray computed

收稿日期: 2018-11-23

PACS:	Ｒ332.2
	Ｒ814.42

通讯作者: 付泉水，遂宁市中心医院放射科，629000。E-mail：460875557@qq.com

作者简介: 胡纳（1987-），女，四川遂宁人，主管技师。E-mail：nikki2223074@163.com

引用本文:

胡纳，李勇，赵林伟，陈洪，冯英，杨国庆，付泉水. 双源CT虚拟单能技术在支气管动脉血管成像中的应用研究[J]. 中国临床医学影像杂志, 2020, 31(1): 38-41.
HU Na, LI Yong, ZHAO Lin-wei, CHEN Hong, FENG Ying, YANG Guo-qing, FU Quan-shui. A prospective study of virtual monoenergetic for bronchial artery angiography in dual-energy CT. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(1): 38-41.

链接本文:

http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.01.009 或 http://www.jccmi.com.cn/CN/Y2020/V31/I1/38

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