【摘要】：目的:評估不同碘流率(IFR)及不同碘濃度對腹部雙能量CT虛擬平掃(VUE)圖像質量的影響。方法:94例患者使用雙能CT行腹部平掃加三期增強,包含動脈期、門脈期和延遲期。根據(jù)注射碘流率的不同94例患者被隨機分為4組。虛擬平掃圖像在70 keV虛擬單能量圖像條件下得到。測量、計算并記錄每個患者腹主動脈、門靜脈主干、肝臟實質、肝內病灶、胰腺實質、脾臟實質、雙側豎脊肌及腹膜后脂肪共8處感興趣區(qū)的CT值、圖像噪聲、信噪比及對比噪聲比。分別記錄包括常規(guī)平掃及不包括常規(guī)平掃的劑量長度乘積及有效輻射劑量,用以計算潛在可降低的輻射劑量。兩位有經(jīng)驗的放射科醫(yī)師使用5分法分別對主觀圖像質量進行評分并記錄。所得數(shù)據(jù)首先進行單樣本正態(tài)性檢驗。組內數(shù)據(jù)符合正態(tài)分布,使用單因素方差分析CT值、圖像質量、信噪比及對比噪聲比值等客觀指標;對于有數(shù)據(jù)不符合正態(tài)分布的情況,則使用非參數(shù)檢驗。由于進行了多組檢驗比較,統(tǒng)計學顯著型水準校正為0.01(雙側)。結果:4個不同碘流率組各組間相同期相的虛擬平掃圖像之間CT值比較沒有統(tǒng)計學差異(P0.05)。同一碘流率組動脈期、靜脈期及平衡期分別獲得的虛擬平掃圖像與常規(guī)平掃圖像之間CT值比較沒有統(tǒng)計學差異(P0.05)。虛擬平掃圖像的信噪比值明顯高于常規(guī)平掃圖像(P0.01);虛擬平掃圖像的對比噪聲比值相等于或略高于常規(guī)平掃圖像(P0.05)。虛擬平掃圖像的主觀評價得分相等于或略低于常規(guī)平掃圖像(P0.05),可以滿足臨床診斷需要。使用虛擬平掃圖像代替常規(guī)平掃圖像可潛在降低輻射劑量約25%。結論:虛擬平掃圖像可以部分代替常規(guī)平掃圖像,且虛擬平掃的圖像質量不會受到碘流率變化的影響。在不影響診斷的前提下使用虛擬平掃圖像可潛在降低輻射劑量約25%。
[Abstract]:Aim: to evaluate the effect of different iodine flow rate (IFR) and different iodine concentration on the quality of abdominal dual energy CT virtual plain scan (VUE) images. Methods: 94 patients with dual energy CT were performed abdominal plain scan and three stages of enhancement, including arterial phase, portal phase and delayed phase. According to the different iodine flow rate, 94 patients were randomly divided into 4 groups. The virtual plain scan image is obtained under the condition of 70 keV virtual single energy image. To measure, calculate and record the CT value and image noise of 8 regions of interest in abdominal aorta, portal vein trunk, hepatic parenchyma, intrahepatic lesion, pancreatic parenchyma, splenic parenchyma, bilateral spinal muscle and retroperitoneal fat in each patient. SNR and contrast noise ratio. The dose length product and effective radiation dose, including conventional plain scan and non-conventional plain scan, were recorded respectively to calculate the potentially reduced radiation dose. Two experienced radiologists scored and recorded subjective image quality using a 5-point method. The obtained data are first tested by single sample normality test. The data in the group were in accordance with normal distribution, and the objective indexes such as CT value, image quality, signal-to-noise ratio and contrast noise ratio were used, and the non-parametric test was used for the cases where the data did not conform to the normal distribution. The statistical significant leveling correction was 0.01 (bilateral) as a result of multiple test comparisons. Results: there was no significant difference in CT between the four different iodine flow rate groups (P0.05). In the same iodine flow rate group, there was no significant difference in CT between the virtual plain scan images and the conventional plain scan images in arterial phase, venous phase and equilibrium phase (P0.05). The signal-to-noise ratio of the virtual plain scan image was significantly higher than that of the conventional plain scan image (P0.01); the contrast noise ratio of the virtual plain scan image was equal or slightly higher than that of the conventional plain scan image (P0.05). The subjective evaluation score of virtual plain scan image is equal to or slightly lower than that of conventional plain scan image (P0.05), which can meet the need of clinical diagnosis. Using virtual plain scan images instead of conventional plain scan images can potentially reduce radiation dose by about 25%. Conclusion: the virtual plain scan image can partly replace the conventional plain scan image, and the image quality of the virtual plain scan image is not affected by the change of iodine flow rate. Using virtual plain scan images without affecting diagnosis can potentially reduce radiation dose by about 25%.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R816.5

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