肝脏成像中Revolution能谱CT虚拟平扫替代真实平扫的可行性研究-现代医学

肝脏成像中Revolution能谱CT虚拟平扫替代真实平扫的可行性研究

单位：1. 南京医科大学第一附属医院放射科, 江苏南京 210029;
2. 东南大学附属中大医院放射科, 江苏南京 210009

分类号：R445.3

出版年·卷·期（页码）：2021·49·第十期（1159-1166）

摘要：

目的：探讨肝脏成像中Revolution能谱CT虚拟平扫（VNC）替代真实平扫（TNC）的可行性及影响因素。方法：回顾性分析2020年8月至2020年10月的120例在Revolution能谱CT上行腹部TNC及动脉（A）、静脉（V）及延迟（D）三期能谱增强扫描的患者资料。测量TNC及三期VNC图像中的肝脏、门静脉、腹主动脉及脂肪的CT值及噪音，比较VNC和TNC间的差异和相关性。多因素回归分析观察VNC与TNC的CT差值（DDVT）影响因素。Wilcoxon检验比较传统扫描与不同方案的能谱增强扫描辐射剂量的差异。结果：VNC_V中肝脏、VNC_A中门静脉、VNC_D中主动脉的CT值与相应TNC差异无统计学意义并呈中等以上正相关；脂肪三期VNC较TNC的CT值偏高并呈强相关；各组织VNC_V与VNC_D的CT值差异无统计学意义。DDVT主要与体重、体表面积或体重指数呈负相关。各期VNC图像噪音均低于TNC，其中VNC_V最低。传统四期扫描的剂量与三期能谱增强扫描差异无统计学意义，高于单期能谱结合混合能量扫描。结论：基于Revolution能谱CT的肝脏VNC_A、VNC_V和VNC_D图像中，VNC_V图像最接近TNC，并能通过体重或体表面积进一步矫正。

Objective: To investigate the feasibility and influence factor of virtual non-contrast images(VNC) derived from GE Revolution spectral CT to replace true non-contrast images(TNC) during liver imaging.Methods: 120 cases from August to October in 2020 with TNC and tri-phase(arterial, venous and delayed phase) spectrum enhancement scan of liver were retrospectively enrolled. CT attenuation and image noise were measured in regions of liver, portal vein, abdominal aorta and fat in TNC and tri-phase VNC images respectively. The differences and correlations between VNC and TNC were analyzed. Multivariate regression analysis was used to investigate the influencing factors of the density difference between VNC and TNC(DDVT). Radiation doses of conventional and spectrum enhanced scanning protocol were compared by Wilcoxon test. Results: The attenuation of liver in VNC_v, portal vein in VNC_A, and aorta in VNC_D had no significant difference and moderate or above correlation with the corresponding TNC. The attenuations of fat in tri-VNC were all higher than TNC and strongly correlated with TNC. The attenuations of the above tissue between VNC_V and VNC_D had no significant difference. DDVT was negatively correlated with weight, body surface area(BSA), or body mass index(BMI) in phases which TNC and VNC were statistically different. The image noise in VNCs were lower than TNC and lowest value was found in VNC_V. The radiation dose of conventional quart-phase scanning had no significant difference with tri-phase spectrum scanning, and higher than that of single-phase spectrum combined with conventional scanning. Conclusions: Among VNC_A, VNC_V and VNC_D based on GE Revolution spectral CT, VNC_V provide closest attenuations to those of TNC and the differences can be mitigated by modification according to weight or BSA during liver imaging.

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