本文選題：腸疾病 + 體層攝影術(shù)　； 參考：《中國(guó)臨床醫(yī)學(xué)影像雜志》2017年04期

【摘要】：目的:探討雙源CT虛擬平掃在小腸病變中的應(yīng)用。方法:對(duì)35位患者在雙源CT上行小腸造影檢查,共三期掃描,即常規(guī)平掃、動(dòng)脈期和靜脈期對(duì)比增強(qiáng)雙能量掃描(100 k V/140 k V),調(diào)入后處理軟件中的Liver VNC選項(xiàng)卡,獲得動(dòng)、靜脈期虛擬平掃圖像,將其與真實(shí)平掃圖像進(jìn)行對(duì)比。對(duì)圖像質(zhì)量進(jìn)行主觀評(píng)分以及客觀評(píng)分,主觀評(píng)分由2名醫(yī)生采用雙盲法評(píng)分,客觀評(píng)分在3個(gè)序列的圖像上選擇感興趣區(qū),分別記錄下動(dòng)、靜脈期虛擬平掃及真實(shí)平掃的病灶、肝臟、肌肉、脂肪的平均CT值,以及由機(jī)器產(chǎn)生的噪聲,病灶的信噪比(SNR)及對(duì)比信噪比(CNR)。同時(shí)記錄下三期掃描的總輻射劑量及去除平掃劑量之后動(dòng)、靜脈增強(qiáng)兩期掃描的總輻射劑量。采用單因素方差分析比較兩組以上圖像平均CT值、SNR、CNR。采用兩個(gè)獨(dú)立樣本t檢驗(yàn)分析輻射劑量。結(jié)果:35例患者,其中男16例,女19例,年齡27~83歲,未見(jiàn)明顯異常16例,慢性結(jié)腸炎3例,粘連性腸梗阻4例,腫瘤切除術(shù)后2例,腸息肉3例,脂肪瘤2例,結(jié)腸惡性腫瘤3例,腸系膜纖維瘤1例,回盲部腫物1例。采用SPSS 21.0軟件進(jìn)行統(tǒng)計(jì)分析,病灶、脂肪、肌肉虛擬平掃的CT值小于真實(shí)平掃,差異有統(tǒng)計(jì)學(xué)意義,而肝臟虛擬平掃的CT值大于真實(shí)平掃,差異有統(tǒng)計(jì)學(xué)意義。虛擬平掃的標(biāo)準(zhǔn)差低于真實(shí)平掃,而SNR、CNR高于真實(shí)平掃,差異無(wú)統(tǒng)計(jì)學(xué)意義。3種圖像主觀評(píng)分均能滿(mǎn)足診斷要求,雖然虛擬平掃的主觀評(píng)分要低于真實(shí)平掃,但是其差異無(wú)統(tǒng)計(jì)學(xué)意義,優(yōu)質(zhì)圖像率達(dá)71.8%。雙能兩期掃描輻射劑量低于常規(guī)三期掃描的24.8%。結(jié)論:在患者小腸造影的檢查中,雙能CT的虛擬平掃圖像可以用作基準(zhǔn)的密度測(cè)量及傳統(tǒng)平掃的替代,省去常規(guī)增強(qiáng)前掃描,大大降低患者接受的輻射劑量。
[Abstract]:Objective: to explore the application of double source CT virtual plain scan in small intestinal lesions. Methods: 35 patients were examined by double source CT uplink enterography, including routine plain scan, arterial phase and venous phase contrast enhanced dual energy scan (100kV / 140k V), and Liver VNC tab in post-processing software. Venous phase virtual plain scan images were compared with real plain scan images. Subjective score and objective score were used to evaluate the image quality. The subjective score was scored by two doctors with double blind method. The objective score was selected on the image of three sequences and recorded separately. The mean CT values of the focus, liver, muscle and fat, the noise produced by the machine, the SNR of the lesion and the contrast signal-to-noise ratio (CNR) of the virtual plain scan and the real plain scan in venous phase. At the same time, the total radiation dose of three phase scanning and the total radiation dose after removing the plain scan dose and vein enhancement were recorded. Single factor analysis of variance (ANOVA) was used to compare the average CT value of more than two groups. Two independent samples were used to analyze the radiation dose. Results among 35 patients, 16 were male, 19 were female, the age was 2783 years old. There were no obvious abnormality in 16 cases, chronic colitis in 3 cases, adhesive intestinal obstruction in 4 cases, tumor resection in 2 cases, intestinal polyp in 3 cases, lipoma in 2 cases. There were 3 cases of colon malignant tumor, 1 case of mesenteric fibroma and 1 case of ileocecal tumor. The CT value of virtual plain scan of focus, fat and muscle was lower than that of real plain scan, the difference was statistically significant, while the CT value of virtual plain scan of liver was larger than that of real plain scan, and the difference was statistically significant. The standard deviation of virtual plain scan is lower than that of real plain scan, while SNRN CNR is higher than that of real plain scan. There is no statistical significance between the subjective scores of virtual plain scan and real plain scan. The subjective score of virtual plain scan is lower than that of real plain scan, although the subjective score of virtual plain scan is lower than that of real plain scan. But its difference has no statistical significance, the high quality image rate reaches 71.8%. The radiation dose of dual energy two phase scan was lower than that of routine 3 phase scan 24. 8%. Conclusion: the virtual plain scan of dual energy CT can be used as the standard density measurement and the replacement of conventional plain scan in the examination of small intestine.
【作者單位】： 新疆維吾爾自治區(qū)人民醫(yī)院放射影像中心;
【基金】：新疆自然科學(xué)基金(2015211C189)
【分類(lèi)號(hào)】：R574.5;R816.5

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