| 赵赛,刘治超,马泽鹏,张天乐,赵永霞.宝石能谱成像不同噪声指数肝脏CT血管造影联合不同浓度对比剂用于超重及肥胖患者[J].中国医学影像技术,2022,38(12):1867~1871 |
| 宝石能谱成像不同噪声指数肝脏CT血管造影联合不同浓度对比剂用于超重及肥胖患者 |
| Hepatic CT angiography in overweight or obese patients based on gemstone spectral imaging with different noise indexes and concentrations of contrast agent |
| 投稿时间：2022-07-17 修订日期：2022-08-28 |
| DOI：10.13929/j.issn.1003-3289.2022.12.022 |
| 中文关键词: 噪声 对比剂 CT血管造影术 宝石能谱成像 图像质量 |
| 英文关键词:noise contrast media computed tomography angiography gemstone spectral imaging image quality |
| 基金项目:河北省2020年度重点研发计划（203777650）、河北省2020年度政府资助临床医学优秀人才培养和基础课题研究项目（361007）、河北省2020年度医学科学研究课题计划（20200572）、河北大学医学学科培育项目（2021X06）保定市科技计划（2141ZF307）。 |
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| 中文摘要: |
| 目的 观察以宝石能谱成像（GSI）不同噪声指数（NI）及不同浓度对比剂对超重[24 kg/m2 ≤ 体质量指数（BMI）<28 kg/m2]或肥胖（BMI ≥ 28 kg/m2）患者行肝脏CT血管造影（CTA）的图像质量、辐射剂量和碘摄入量，筛选最佳参数组合。方法 将90例超重或肥胖患者随机分为A、B、C组3组，每组30例；以GSI行肝脏CTA，分别设置NI为7、11及15，对比剂浓度分别为370、350及320 mgI/ml。根据各组原始图像重建40~60 keV（间隔5 keV）单能量图像，分析各组内不同单能量图中肝动脉、门静脉和肝静脉的CT值、噪声[标准差（SD）]、对比度噪声比（CNR）及图像质量主观评分结果；比较最佳单能量图所见各参数组间差异，计算体型特异性剂量估算值（SSDE）和碘摄入量。结果 各组40~60 keV单能量图像中，肝动脉、门静脉和肝静脉CT值及SD值均随keV增加而降低（P均<0.001）；40 keV单能量图像中肝动脉、门静脉和肝静脉CNR及图像质量主观评分高于50~60 keV（P均<0.05）及55~60 keV图像（P均<0.05），均以40 keV为最佳单能量水平；3组最佳单能量图所示上述各参数差异均无统计学意义（P均>0.05）。B、C组SSDE和碘摄入量均低于A组（P均<0.05），C组SSDE和碘摄入量均低于B组（P均<0.05）。结论 基于GSI采用高NI（15）联合低浓度碘对比剂（320 mgI/ml）可在保证图像质量的前提下降低超重及肥胖患者肝脏CTA的辐射剂量和碘摄入量。 |
| 英文摘要: |
| Objective To observe the image quality, radiation dose and iodine intake of hepatic CT angiography (CTA) based on gemstone spectral imaging (GSI) with different noise indexes (NI) and concentrations of contrast agent in overweight (24 kg/m2 ≤ body mass index[BMI] < 28 kg/m2) or obese (BMI ≥ 28 kg/m2) patients, and to screen the best combination of scanning parameters. Methods Ninety overweight or obese patients who would undergo hepatic CTA were prospectively collected and randomly divided into A, B and C group (each n=30), with NI of 7, 11,15 and iodine concentrations of 370, 350 and 320 mgI/ml, respectively. The single-energy images at 40-60 keV (5 keV interval) were reconstructed from the original images. CT value, noise (standard deviation[SD] value), contrast-to-noise ratio (CNR) and subjective score of hepatic artery, portal vein and hepatic vein on different single-energy images were analyzed to screen the optimal single-energy image of each group. The above parameters on the optimal single-energy images were compared among groups, and the size-specific dose estimates (SSDE) and iodine intake were analyzed. Results CT and SD values of hepatic artery, portal vein and hepatic vein in 40-60 keV single-energy images decreased with the increase of keV in all 3 groups (all P<0.001). CNR and subjective scores of hepatic artery, portal vein and hepatic vein on 40 keV single-energy images were all higher than those on 50-60 keV (all P<0.05), and CNR and subjective scores of hepatic artery, portal vein and hepatic vein on 45 keV single-energy images were higher than those on 55-60 keV (all P<0.05), indicating that 40 keV was the optimal single-energy level. No significant difference of CT, SD, CNR nor subjective scores of hepatic artery, portal vein and hepatic vein on the optimal single energy images was found among 3 groups (all P>0.05). SSDE and iodine intakes of B and C groups were lower than those of group A, and of group C were lower than those of group B (both P<0.05). Conclusion Based on GSI, high NI (15) combined with low concentration contrast agent (320 mgI/ml) could reduce radiation dose and iodine intake and ensure image quality of hepatic CTA of overweight or obese patients. |
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