ISSN 1004-4140
    CN 11-3017/P

    双能量CT虚拟平扫代替真实平扫用于降低克罗恩病小肠造影辐射剂量

    Dual-energy CT Virtual Non-contrast as a Low-radiation Alternative to True Non-contrast in Crohn’s Disease Enterography

    • 摘要: 目的:探讨双能量CT虚拟平扫(VNC)代替真实平扫(TNC)用于降低克罗恩病小肠造影辐射剂量的应用价值。方法:获取2024年6月至2024年12月在南京医科大学第一附属医院53例克罗恩患者双能量小肠造影图像,利用双能量分析软件重建获得动脉期和静脉期的虚拟平扫图像,采用单因素方差分析对常规平扫和动、静脉期虚拟平扫图像的CT值、信号噪声比(SNR)、对比噪声比(CNR)进行评价;采用5分法对图像质量进行主观评价,采用秩和检验分析。结果:TNC、VNCa及VNCv的图像质量主观评分分别为4(4,5)、4(4,5)、4(4,5),且差异不具有统计学意义。TNC、VNCa及VNCv之间,病变肠壁、正常肠壁、下腔静脉、竖脊肌、肝脏的CT值差异不具有统计学意义。病变肠壁、正常肠壁、腹主动脉、下腔静脉、肝脏的SNR值差异具有统计学意义且VNCa及VNCv的SNR值均高于TNC。病变肠壁、正常肠壁、下腔静脉、肝脏的CNR值差异不具有统计学意义。VNCv较TNC小肠CT造影(CTE)扫描的辐射剂量大约降低了30%。结论:双能量CT虚拟平扫代替真实平扫在保证图像质量的同时可以降低克罗恩病小肠造影辐射剂量,可以在临床应用中推广。

       

      Abstract: Abstract: Objective: To explore the application value of dual-energy CT virtual non-contrast (VNC) instead of true non-contrast (TNC) in reducing the radiation dose of small intestine radiography in Crohn's disease. Methods: Dual-energy enterography images of 53 patients with Crohn's disease in the First Affiliated Hospital of Nanjing Medical University from June 2024 to December 2024 were obtained. Virtual non-contrast images of the arterial phase and venous phase were reconstructed using dual-energy analysis software. One-way analysis of variance was used to evaluate the CT values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of conventional plain scan and virtual plain scan images in the arterial and venous phases. The image quality was subjectively evaluated by the 5-point method and analyzed by the rank sum test. The subjective image quality scores of TNC, VNCa and VNCv were 4 (4, 5), 4 (4, 5) and 4 (4, 5) respectively, and the difference was not statistically significant. There was no statistically significant difference in the CT values of the diseased intestinal wall, normal intestinal wall, inferior vena cava, erector spinae muscle and liver among TNC, VNCa and VNCv. The SNR values of the diseased intestinal wall, normal intestinal wall, abdominal aorta, inferior vena cava and liver were statistically significant, and the SNR values of VNCa and VNCv were both higher than those of TNC. There was no statistically significant difference in the CNR values among the diseased intestinal wall, normal intestinal wall, inferior vena cava and liver. The radiation dose of VNCv scan is approximately 30% lower than that of TNC CTE scan. Conclusion: The virtual non-contrast of dual-energy CT instead of the true non-contrast can reduce the radiation dose of enterography in Crohn's disease while ensuring image quality, and can be promoted in clinical applications.

       

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