本文選題：下肢動(dòng)脈硬化閉塞 + 對(duì)比劑　； 參考：《東南大學(xué)》2017年碩士論文

【摘要】：目的 探討能譜CT最佳單能量成像技術(shù)在下肢動(dòng)脈成像中降低碘對(duì)比劑用量的可行性。方法 前瞻性的連續(xù)選擇行下肢CT動(dòng)脈成像檢查患者75例,按掃描方式及對(duì)比劑用量分為三組:傳統(tǒng)常規(guī)劑量組、能譜常規(guī)劑量組及能譜低劑量組。傳統(tǒng)常規(guī)劑量組及能譜常規(guī)劑量組均采用2mL/kg的對(duì)比劑用量及3.5mL/s的注射速率,掃描方式及重建方法前者采用120kVp、濾波反投影算法(FBP)重建,后者采用能譜模式、50%自適應(yīng)統(tǒng)計(jì)迭代(50%ASiR)重建。能譜低劑量組的對(duì)比劑用量及注射速率均降低20%,采用能譜模式及50%ASiR重建。測(cè)量三組圖像靶血管的CT值,并記錄對(duì)比噪聲比(CNR)、背景噪聲(BN)、劑量長(zhǎng)度乘積(DLP)、有效輻射劑量(ED)、攝碘量及注射速率,采用單因素方差分析并聯(lián)合Bonferroni法進(jìn)行差異性檢驗(yàn)。采用Kruskal-Wallis檢驗(yàn)對(duì)三組圖像質(zhì)量主觀評(píng)分進(jìn)行比較分析。結(jié)果 按排除標(biāo)準(zhǔn),最終60例患者納入本研究,三組患者各20例。能譜常規(guī)劑量組有著最佳的CT值、CNR及BN(P0.01),但BN與能譜低劑量組相比無統(tǒng)計(jì)學(xué)差異(P0.05);能譜低劑量組的CT值及CNR除脛前動(dòng)脈外(P=0.162;P=0.376),均高于傳統(tǒng)常規(guī)劑量組(P0.05)。兩能譜組的ED均顯著低于傳統(tǒng)組(P0.01),且兩能譜組間無統(tǒng)計(jì)學(xué)差異(P0.05)。此外,能譜低劑量組攝碘量及注射速率均顯著低于能譜常規(guī)劑量組及傳統(tǒng)組(P0.01)。醫(yī)師1、2對(duì)三組圖像的主觀評(píng)分分別為82分、95分、90分和80分、96分、89分,具有統(tǒng)計(jì)學(xué)差異(H=4.954,P0.01;H=17.726,P0.01),能譜常規(guī)劑量組有著最佳的圖像質(zhì)量,能譜低劑量組的圖像質(zhì)量?jī)?yōu)于傳統(tǒng)常規(guī)劑量組(P0.05)。結(jié)論 能譜最佳單能量成像與傳統(tǒng)螺旋CT相比,可以提供更好的CNR及圖像質(zhì)量,在保證下肢動(dòng)脈成像臨床診斷的基礎(chǔ)上明顯降低了輻射劑量,同時(shí)個(gè)性化減少了對(duì)比劑碘的攝入量。
[Abstract]:Objective to study the feasibility of reducing the amount of iodine contrast agent in lower extremity arteriography with the best single energy imaging technique of energy dispersive CT. Methods Seventy-five patients with prospective CT arteriography were divided into three groups: conventional dose group, conventional dose group and low dose group. The conventional dose group and the energy spectrum routine dose group were reconstructed by 2mL/kg contrast agent dosage and 3.5mL/s injection rate. The former was reconstructed by 120kVpfilter backprojection algorithm. The latter is reconstructed by 50% adaptive statistical iteration of energy spectrum mode. The dosage of contrast agent and injection rate of low dose group were decreased by 20%. Energy spectrum mode and 50%ASiR reconstruction were used. The CT values of the target vessels in the three groups were measured, and the contrast noise ratio (CNR), background noise (BNP), dose length product (DLP), effective radiation dose (EDN), iodine uptake and injection rate were recorded. The differences were tested by univariate ANOVA and Bonferroni method. The subjective scores of three groups of image quality were compared and analyzed by Kruskal-Wallis test. Results according to the exclusion criteria, 60 patients were included in the study, 20 patients in each group. The conventional dose group had the best CT value, CNR and BNN P0.01g, but there was no significant difference in BN between the low dose group and the low dose group, and the CT value and CNR in the low dose group were higher than those in the conventional group, except for the anterior tibial artery. Ed of the two groups was significantly lower than that of the traditional group, and there was no statistical difference between the two groups. In addition, the iodine uptake and injection rate in the low dose group were significantly lower than those in the conventional dose group and the traditional group. The subjective scores of the three groups were 82, 95, 90 and 80, respectively, with statistical difference of 4.954 (P 0.01) and 17.726 (P 0.01). The image quality of the low dose group was better than that of the conventional dose group (P 0.05). Conclusion compared with conventional spiral CT, the best energy spectrum single energy imaging can provide better CNR and image quality, and can obviously reduce the radiation dose on the basis of ensuring the clinical diagnosis of lower extremity arterial imaging. At the same time, individualization reduced the iodine intake of contrast agent.
【學(xué)位授予單位】：東南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R816.2;R543.5

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