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虚拟平扫代替真实平扫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例克罗恩病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、SNR、CNR进行评价;采用5分法对图像质量进行主观评价,并采用秩和检验分析。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TNV 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: Objective: To investigate the value of dual-energy computed tomography (CT) virtual plain scans in reducing the radiation dose of small intestine angiography for Background: Crohn’s disease enterography tends to involve multiple computed tomography (CT) scans, which can expose patients to more radiation and additional complications. This study evaluates the feasibility of using dual-energy CT virtual non-contrast (VNC) imaging as a low-radiation alternative to true non-contrast (TNC) imaging. Methods: Dual-energy small-bowel imaging was performed on 53 patients with Crohn’s condition at the First Affiliated Hospital of Nanjing Medical University from June 2024 to December 2024. Virtual normal scan images of the arterial (VNCa) and venous phases (VNCv) were reconstructed using dual-energy analysis software. CT values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the conventional and virtual plain scans were analyzed using one-way ANOVA. Image quality was evaluated subjectively using a five-point grading system and analyzed with the rank sum test. Results: The subjective scores of the TNC, VNCa, and VNCv were 4 (4, 5), 4 (4, 5), and 4 (4, 5), with no statistically significant differences. The CT values of the pathological intestinal wall, normal intestinal wall, inferior vena cava, erector spinae muscle, and liver showed no significant differences among TNC, VNCa, and VNCv. SNR values of the pathological intestinal wall, normal intestinal wall, abdominal aorta, inferior vena cava, and liver were significantly higher in VNCa and VNCv than in TNC. There were no significant differences observed in the CNR values across the groups. The radiation dose of the VNCv was approximately 30% lower than that of the TNV CT enterography scan. Conclusion: A dual-energy CT virtual plain scan, rather than an actual plain scan, can reduce the radiation dose of Crohn’s disease enterography without compromising the image quality. This approach has the potential for extensive clinical applications.

     

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