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自适应性统计迭代重建联合低管电压提高肝细胞癌患者肝脏CT三期增强扫描图像质量研究
引用本文:彭光明,葛尚,井桂银.自适应性统计迭代重建联合低管电压提高肝细胞癌患者肝脏CT三期增强扫描图像质量研究[J].实用肝脏病杂志,2021,24(5):737-740.
作者姓名:彭光明  葛尚  井桂银
作者单位:223300 江苏省淮安市 南京医科大学附属淮安第一医院医学影像科(彭光明,葛尚);CT室(井桂银)
摘    要:目的 分析自适应性统计迭代重建(ASIR)联合低管电压用于CT肝脏三期增强扫描诊断原发性肝癌(PLC)对图像质量的影响。方法 2018年5月~2020年5月我院诊治的84例PLC患者,在行腹部CT增强扫描时,38例接受100 kV和ASIR扫描(观察组),另46例接受常规120 kV和滤过反投影(FBP)扫描(对照组)。勾画感兴趣区,记录噪声、信噪比和对比噪声比,参照有关指南对图像质量进行评分,记录CT剂量指数(CTDIvol)和有效剂量(ED)。结果 观察组动脉期、门静脉期和延迟期噪声分别为(9.4±1.5)HU、(9.5±2.0)HU和(9.8±1.8)HU,显著低于对照组【分别为(10.3±1.7)HU、(10.5±2.1)HU和(10.7±2.0)HU,P<0.05】,动脉期和延迟期信噪比分别为(9.1±1.6)和(10.6±2.1),显著高于对照组【分别为(8.2±1.8)和(9.7±1.7),P <0.05】,动脉期和延迟期对比信噪比分别为(3.1±0.9)和(4.6±1.5),显著高于对照组【分别为(2.4±1.0)和(3.6±1.4),P <0.05】;观察组动脉期噪声、细小结构、病变显示和伪影评分分别为(1.4±0.6)分、(1.6±0.7)分、(1.2±0.6)分和(1.2±0.5)分,显著低于对照组【分别为(2.0±0.7)分、(2.7±0.9)分、(1.7±0.9)分和(1.6±0.8)分,P <0.05】,延迟期噪声、细小结构、病变显示和伪影评分分别为(1.5±0.7)分、(1.7±0.8)分、(1.6±0.6)分和(1.4±0.6)分,显著低于对照组【分别为(1.9±0.5)分、(2.4±0.8)分、(2.0±0.7)分和(1.9±0.7)分,P<0.05】;观察组CTDIvol 为(6.4±1.7)mGy,显著低于对照组【(7.3±1.8)mGy,P<0.05】,ED为(2.3±0.7)mSv,显著低于对照组【(2.8±0.8)mSv,P <0.05】。结论 采用ASIR结合低管电压CT扫描诊断PLC患者能满足图片质量要求,降低了CT辐射剂量,提高了检查的安全性,值得临床探讨使用。

关 键 词:原发性肝癌  CT扫描  自适应性统计迭代重建  低管电压  图像质量  辐射剂量  
收稿时间:2021-03-08

Image quality of adaptive statistical iterative reconstruction under low tube voltage of CT scan in diagnosis of patients with primary liver cancer
Peng Guangming,Ge Shang,Jin Guiyin.Image quality of adaptive statistical iterative reconstruction under low tube voltage of CT scan in diagnosis of patients with primary liver cancer[J].Journal of Clinical Hepatology,2021,24(5):737-740.
Authors:Peng Guangming  Ge Shang  Jin Guiyin
Affiliation:Department of Radiology, First People’s Hospital Affiliated to Nanjing Medical University, Huaian 223300,Jiangsu Province, China
Abstract:Objective The aim of this study was to investigate the image quality ofadaptive statistical iterative reconstruction (ASIR) under low tube voltage of CT scan in diagnosis of patients with primary liver cancer (PLC) . Methods 84 patients with PLC were encountered in our hospital between May 2018and May 2020, and all patients underwent CT examination, with ASIR under 100 kV scan in 38 patients (observation group) and filtered back projection (FBP) under normal 120kV scan in 46 patients (control group). The subjective indicators, such as noise, artifact, small structure, lesion display score, the Objective indicators, such as noise, signal to noise ratio and contrast signal to noise ratio in arterial phase, portal venous phase and delayed phase, and the CT dose index of volume (CTDIvol) and effective dose (ED) were recorded. Results The noise levels in arterial phase, portal vein phase and delayed phase in the observation group were (9.4±1.5) HU, (9.5±2.0) HU and (9.8±1.8) HU, significantly lower than in the control group, the signal-to-noise ratio in arterial phase and in delayed phase in the observation group were (9.1±1.6) and (10.6±2.1), significantly higher than in the control group, and the contrast signal to noise ratio in arterial phase and in delayed phase in the observation group were (3.1±0.9) and (4.6±1.5), significantly higher than in the control group; the scores of noise, fine structure, lesion display and artifact in arterial phase in the observation group were (1.4±0.6), (1.6±0.7),(1.2±0.6) and (1.2±0.5), significantly lower than in the control group; the score of noise, fine structure, lesion display and artifact in the delay phase in the observation group were (1.5±0.7),(1.7±0.8),(1.6±0.6) and (1.4±0.6), significantly lower than in the control group; the CTDIvol in the observation group was (6.4±1.7) mGy, significantly lower than and the ED was (2.3±0.7) mSv, significantly lower than in the control group. Conclusion The application of ASIR under low tube voltage fulfills the diagnostic requirement with good CT image quality and less radiation inpatients with PLC, which might need further clinical investigations.
Keywords:Hepatoma  Adaptive statistical iterative reconstruction  Low tube voltage  Image quality  Radiation dose  
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