| 张竞颐,刘义军,王诗耕,童小雨,范勇,陈安良,胡梦婷,程启烨.基于去脂体质量对比剂注射方案用于能谱CT检查结直肠癌[J].中国医学影像技术,2024,40(3):441~445 |
| 基于去脂体质量对比剂注射方案用于能谱CT检查结直肠癌 |
| Lean body wight dose determined contrast injection protocol in spectral CT of colorectal cancer |
| 投稿时间：2023-10-26 修订日期：2023-12-21 |
| DOI：10.13929/j.issn.1003-3289.2024.03.025 |
| 中文关键词: 结直肠肿瘤 体层摄影术,X线计算机 前瞻性研究 去脂体质量 |
| 英文关键词:colorectal neoplasms tomography, X-ray computed prospective studies lean body weight |
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| 中文摘要: |
| 目的 评估基于去脂体质量(LBW)低剂量对比剂注射方案对于能谱增强 CT显示结直肠癌图像质量的影响,并筛选最佳能级。方法 将150例疑诊结直肠肿物患者随机分为总体质量(TBW)组(A组)、500LBW组(B组)及400LBW组(C组)各50例,分别以500 mgI/kg(TBW)、500 mgI/kg(LBW)、400 mgI/kg(LBW)方案注射对比剂,行能谱CT全腹增强扫描。对A、B组重建70 keV图像,C组重建40~70 keV(间隔10 keV)图像(C40~70 keV亚组),测量动脉期肠系膜上动脉(SMA)、肠系膜下动脉(IMA)和静脉期肝实质CT值,计算信噪比、对比度噪声比和肝脏增强CT值(ΔHU),比较各组图像质量。结果 相比A组,B、C组对比剂剂量分别降低23.00%及37.19%(P均＜0.05)。动脉期A、B组及C40~60 keV亚组SMA和IMA的CT值均＞350 HU。B组SMA及IMA的CT值变异率分别为9.42%和9.32%,C60 keV亚组SMA和IMA的CT值变异率分别为9.82%和10.09%,均低于A组(P均＜0.05)。静脉期中,A、B组及C40~60 keV亚组的ΔHU均＞50 HU。B组和C60 keV亚组ΔHU变异率分为8.60%和8.67%,均低于A组(P＜0.05)。3组动、静脉期结直肠癌标准化碘浓度差异均无统计学意义(P均＞0.05)。C组内C60 keV亚组动、静脉期主观评分均最高,且与A组差异无统计学意义(P均＞0.05);其余各亚组主观评分均低于A组(P均＜0.05)。结论 基于LBW低剂量对比剂注射方案结合能谱CT可利用低对比剂剂量获得高质量图像;60 keV为最佳扫描能级。 |
| 英文摘要: |
| Objective To observe the impact of lean body weight (LBW) dose determined contrast injection protocol on imaging quality of contrast enhanced spectral CT for dispalying colorectal cancer, and to select the optimal scanning energy level. Methods Totally 150 patients with suspected colorectal tumors were prospectively enrolled and randomly divided into total body weight (TBW) group (group A), 500LBW group (group B) and 400LBW group (group C) (each n=50). Contrast-enhanced abdominal spectral CT images were acquired with contrast medium of 500 mgI/kg (TBW), 500 mgI/kg (LBW) or 400 mgI/kg (LBW) in group A, B and C, respectively, and then 2-phase iodine-based material decomposition images were reconstructed. Images in group A and B were reconstructed at 70 keV, while in group C was reconstructed 40—70 keV (with 10 keV interval) (C40-70 keV subgroups). CT values of arterial phase superior mesenteric artery (SMA) and inferior mesenteric artery (IMA), as well as of liver in venous phase were measured. Then signal-to-noise ratio, contrast-to-noise ratio and liver enhanced CT value (ΔHU) were calculated, and imaging qualities were comparatively analyzed. Results Compared with group A, the contrast media doses of B group and C group decreased by 23.00% and 37.19%, respectively (both P＜0.05). During arterial phase, CT values of SMA and IMA in group A, B and C40-60 keV subgroups images were all over 350 HU. The variation rate of CT value of SMA and IMA in group A was 9.42% and 9.32%, while in C60 keV was 9.82% and 10.09%, respectively, all lower than those in group A (all P＜0.05). During venous phase, ΔHU in images of group A, B and C40-60 keV subgroups were all over 50 HU. The variation rate of ΔHU in group B and C60 keV was 8.60% and 8.67%, respectively, both lower than in group A (both P＜0.05). No significant difference of arterial nor venous phases normalized iodine concentration was found among 3 groups (both P＞0.05). In group C, C60 keV subgroup had the highest subjective scores in both arterial and venous phases, which were not significantly different with those in group A (both P＞0.05), while subjective scores of other subgroups were lower than that in group A(all P＜0.05). Conclusion Low contrast injection protocol based on LBW combined with spectral CT could provide high quality images and reducing dose of contrast media. 60 keV was the most recommended level for scanning. |
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