| 张乐乐,朱丽娜,聂可卉,谷艳博,李莉明,高剑波.以光子计数CT虚拟平扫替代常规CT平扫评估结直肠癌[J].中国医学影像技术,2026,42(3):448~452 |
| 以光子计数CT虚拟平扫替代常规CT平扫评估结直肠癌 |
| Photon-counting CT virtual non-contrast replacing conventional non-contrast CT for evaluating colorectal cancer |
| 投稿时间：2025-11-04 修订日期：2026-02-23 |
| DOI：10.13929/j.issn.1003-3289.2026.03.026 |
| 中文关键词: 结直肠肿瘤 体层摄影术,X线计算机 光子 辐射剂量 前瞻性研究 |
| 英文关键词:colorectal neoplasms tomography,X-ray computed photons radiation dosage prospective studies |
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| 摘要点击次数: 70 |
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| 中文摘要: |
| 目的 探讨光子计数CT(PCCT)虚拟平扫替代常规CT平扫评估结直肠癌的可行性。方法 前瞻性对50例结直肠癌患者行PCCT检查,对真实平扫(TNC)、动脉期虚拟平扫(VNC-AP)、静脉期虚拟平扫(VNC-VP)、动脉期纯净钙化(PC-AP)、静脉期纯净钙化(PC-VP)图像进行主、客观评价;计算双期增强扫描相比平扫+双期增强扫描的有效剂量(ED)下降率。结果 TNC、VNC-AP、PC-AP、VNC-VP及PC-VP图像均符合诊断要求(评分≥3);PC-VP与TNC图像总体质量评分差异无统计学意义(P＞0.05)且均高于VNC-AP、PC-AP及VNC-VP(P均＜0.05);PC-AP、PC-VP与TNC显示病灶清晰度评分差异均无统计学意义(P均＞0.05)且均高于VNC-AP及VNC-VP(P均＜0.05)。基于PC-VP与TNC图所测肿瘤区域、邻近非瘤肠壁及皮下脂肪CT值差异均无统计学意义(P均＞0.05);VNC-AP及VNC-VP图肿瘤及肝脏对比度噪声比(CNR)均低于TNC、PC-AP及PC-VP(P均＜0.05)。相比平扫+双期增强扫描,双期增强扫描ED下降38.92%[(11.72±2.67)mSv vs. (19.19±4.38)mSv]。结论 PCCT PC-VP图像更接近TNC而ED显著降低,可替代常规CT平扫用于评估结直肠癌。 |
| 英文摘要: |
| Objective To investigate the feasibility of photon-counting CT (PCCT) virtual non-contrast in replacing conventional non-contrast CT for evaluating colorectal cancer. Methods PCCT was prospectively performed in 50 patients with colorectal cancer. Subjective and objective evaluation results were compared among true non-contrast (TNC), arterial phase virtual non-contrast (VNC-AP), venous phase virtual non-contrast (VNC-VP), arterial phase pure calcium (PC-AP) and venous phase pure calcium (PC-VP) images. The reduction rate of effective dose (ED) of dual-phase contrast-enhanced scanning relative to non-contrast plus dual-phase contrast-enhanced scanning was calculated. Results TNC, VNC-AP, PC-AP, VNC-VP and PC-VP images all met diagnostic requirements (score≥3). No significant difference of overall imaging quality score was found between PC-VP and TNC (P＞0.05), which of the two were both higher than that of VNC-AP, PC-AP and VNC-VP (all P＜0.05). No significant difference of lesion conspicuity score was observed among PC-AP, PC-VP and TNC (all P＞0.05), of which were higher than those of VNC-AP and VNC-VP (all P＜0.05). No significant difference of CT values of tumor regions, adjacent nontumor intestinal walls nor subcutaneous adipose tissue was found between PC-VP and TNC (all P＞0.05). The contrast-to-noise ratio (CNR) of both tumors and liver on VNC-AP and VNC-VP were lower than those on TNC, PC-AP and PC-VP (all P＜0.05). Compared with non-contrast plus dual-phase contrast-enhanced scanning, ED of dual-phase enhanced scanning alone reduced by 38.92% ([11.72±2.67] mSv vs.[19.19±4.38] mSv). Conclusion PCCT PC-VP were more comparable to TNC images with significantly reduced ED, which was a viable alternative to conventional non-contrast CT for evaluating colorectal cancer. |
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