DR双能量减影的肋骨成像与胸部成像的对比分析

目的：讨论双能量减影对肋骨病变的诊断价值。方法：收集200例患者做胸部数字化X线摄影（DR）双能量减影,对双能量减影后胸廊的肋骨像与胸部的肋骨像进行对比分析。结果：200例中肋骨钙化50例,肋骨破坏7例,肋骨骨折22例。胸廊肋骨及肋骨纹理均显示清晰,符合诊断要求。结论：胸部DR双能量减影对肋骨病变及膈下肋骨显示明显优于胸部肋骨像。     

DR双能量减影骨组组像对肋骨骨折的诊断价值

目的：探讨数字化X线摄影（digital radiography。DR）中的双能量减影（dual—energy subtraction，DES）所成的骨组织像对诊断肋骨骨折的价值．材料与方法：26例胸部外伤可疑肋骨骨折病例。分别常规DR与双能量减影两种摄影技术拍片检查，统计两种方法对肋骨骨折的检出率；结果：DR双能量减影对于隐匿部位和细小骨折的诊出率高于常规DR。结论：运用双能量减影技术摄影对隐匿部位（重叠和切线位）骨折显示更好，能提高诊断准确率。     

DR双能量减影技术在胸部外伤摄影中的临床应用

目的：探讨直接数字化X线摄影（digital radiography,DR）双能量减影技术在胸部外伤摄影的检查方法、成像质量和临床应用价值。方法：分析在DR双能量减影技术下行胸部摄影的56例外伤的病例资料。结果：单纯肋骨骨折37例（其中单处骨折26例、多发骨折11例）,肋骨骨折合并肺挫伤8例,正常11例。结论：DR双能量减影技术可得出3幅图像——标准DR像、软组织像及骨骼像,其成像质量和图像所含信息量是普通单一X线成像所无法比拟的。     

DR双能量减影在肋骨骨折中的诊断价值

目的：总结直接数字平板X线成像系统（digital panel radiography,DR）双能量减影（dual-energy subtraction）技术在胸部肋骨骨折中的诊断价值。方法：对46例患者进行DR双能量减影胸部后前位X线摄影检查,分别获得标准影像、骨组织像和软组织影像;对影像质量进行评价,并比较骨组织像和标准像图像对不同节段肋骨骨折的显示率。结果：46例患者共发现112处肋骨骨折,标准胸片对肋骨后段、腋段和前段骨折的显示率分别为94．1％、82．7％和92．3％,总的显示率为88．4％;而骨组织像对各段肋骨骨折的显示率为97．1％、98．1％和100％,总的显示率为98．2％。χ2=112,P=0．000。结论：双能量减影技术能明显提高肋骨骨折的显示率,在肋骨骨折的诊断中有重要价值。     

双能量减影骨组织像与DR常规像在肋骨骨折诊断中的对比观察

目的:探讨双能量减影骨组织像与DR常规像在肋骨骨折诊断中的应用价值。方法:对48名共计192根临床疑诊肋骨骨折的患者,采用双能量减影法摄胸部正斜位片,获得DR常规像和骨组织像,两组医师分别作出诊断,比较DR常规像、骨组织像诊断的结果。结果:DR常规像、骨组织像对肋骨凹陷状骨折的检出率分别为26.92%、23.08%;对裂隙状骨折的检出率分别为11.11%、66.67%;对错位状骨折的检出率均为100%。DR常规像诊断肋骨骨折的敏感性76.72%,特异性100%,阳性预测值100%,阴性预测值73.79%,准确性85.94%;骨组织像则分别80.17%、97.37%、97.89%、76.29%和86.98%,两组的敏感性和准确性无显著差异(P>0.05)。结论:双能量减影骨组织像有利于细小裂隙状骨折的显示;DR常规像观察凹陷状骨折与骨组织像效果相同或更好,两者对肋骨骨折的诊断能力相当。     

双能量减影在泌尿生殖系统检查中的应用

泌尿生殖系统的X线检查,如泌尿系平片（KUB）,静脉肾盂造影（IVP）,逆行尿路造影（RUV）,输卵管造影等,是诊断泌尿生殖系疾病的重要手段,检查前患者虽大都做了肠道清洁准备,但仍有许多患者肠腔内气体较多,严重干扰了诊断.直接数字X线摄影（DR）的高级临床应用软件-双能量减影用于泌尿生殖系统检查,尤其是造影检查,能有效去除肠腔气体重叠影,提高影像质量及诊断效果.本组随机抽取我院自2004年8月～2005年3月间,DR设备使用以来的100例泌尿生殖系统检查病例,对双能量减影的应用效果进行分析.     

数字化双能量减影技术在胸部肺结节及结节内钙化诊断中的应用价值

目的评价数字化双能量减影技术在肺结节及结节内钙化诊断中的临床价值。方法使用美国GE公司Revolution DR-XR/d数字化摄影系统,为80例患者行胸部双能量摄片,将所获得的3幅图像(肺组织像、肋骨像、原像)进行对比分析。结果经CT证实的186个结节中,减影像共检出肺内结节126个(其中含钙化结节32个,无钙化结节94个);原像共检出肺内结节109个(其中钙化结节26个,无钙化结节83个);两者相比较,减影像对病灶显示更敏感。结论减影像在检出肺内结节及结节内钙化等方面有明显优势,可作为原像的重要补充。     

DR双能量减影技术在胸部摄影中的应用进展

数字X线摄影（digital radiography,DR）图像处理的功能强大,除一般的窗口技术外,某些DR还配备了各种高级应用软件,如时间减影、能量减影和CAD等,使胸部疾病的诊断提升了一个台阶[1]。双能量减影（dual energy subtraction,DES）是DR高级后处理技术,主要应用于胸部摄影,     

数字化双能量减影胸部摄片的临床应用价值

目的 :评价双能量减影胸部摄片的临床应用价值 ,探讨影响图像质量的因素。方法 :选择双能减影检查病人 15 0例 ,其中男 78例 ,女 72例 ,年龄 4～ 88岁 ,平均 4 7岁。使用美国GERevolutionXQ/d全数字摄影系统 ,自动曝光条件下采集数字平片、软组织像及骨组织像。由三名医师对图像进行综合分析 ,统计分析采用卡方检验。结果 :15 0例胸片中有阳性征象者 86例 ,其中钙化 2 9例 ,肺内结节性病变 4 5例 ,肋骨骨折 3例 ,骨病 4例 ,胸部其它病变 5例。胸部钙化检出情况 :数字平片检出 5例 ,骨组织像检出 2 9例 ,其中两者共同检出 5例。两者对胸部钙化的检出率有显著差异 (P <0 .0 1)。对肺内结节的检出情况 :数字平片检出 35例 ,软组织像检出 4 5例 ,两者共同检出 35例 ,两者对肺内结节的检出率经统计学处理无显著差异 (P >0 .0 5 )。左下肺心室搏动伪影、双下肺呼吸运动伪影是软组织像上常见的伪影表现 ,曝光时身体移动是双能减影失败的常见原因。结论 :双能减影可增加诊断的信息量 ,增加胸部钙化的检出率 ,有助于肺内结节性病变细节的观察 ;有利于对肺野边缘、骨性胸廓及大气管影像解剖结构和病变的观察 ;心室搏动、曝光时呼吸及身体移动是影响双能减影成像质量的主要因素。     

双能量数字减影胸片对肺内小结节检出的意义

目的探讨双能量数字减影胸片对肺内小结节检出的意义。方法27例病理证实恶性肿瘤伴肺内转移的患者,分别行增强CT扫描、双能量数字减影胸片与常规DR胸片。使用柯达质量控制检测仪比较双能量数字减影DR与常规DR胸片的图像质量。再以CT扫描结果为金标准,由2位高年资放射科医师采用双盲法对双能量数字减影胸片与常规DR胸片进行分析,比较两者对肺内转移瘤的检出有无显著差异。结果双能量数字减影DR与常规DR图像在噪声上(均匀度)无差异,但清晰度稍差。双能量数字化减影的胸片对肺内小结节的检出率为91.2%;而常规DR胸片对肺转移瘤的检出率为85.0%,两者之间有显著差异(P<0.05)。结论双能量数字减影技术可减少肺野内骨骼及其它钙化影响,对肺内结节的检出能力高于常规DR胸片。     

双能量减影数字X线摄影技术的应用

目的:用双能量减影数字X线摄影提高肺部小结节病变的检出率。方法:双能量减影摄影可以用两次曝光法和一次曝光法来完成。结果:双能量减影数字化胸部摄影技术作为胸部X线检查的一种辅助手段,它能有效的提高肺部小结节病变的检出率,并能增加鉴别诊断的依据。结论:直接数字化X线摄影(DR)的使用,使两次曝光法得以实行。由于两次曝光法能量差大,它产生的双能量减影图像上组织对比良好,图像信噪比高,比一次曝光法具有更明显的优势。     

Bone images from dual-energy subtraction chest radiography in the detection of rib fractures

Objective

To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures.

Materials and methods

In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference.

Results

The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p = 0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p = 0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, p < 0.001).

Conclusions

Despite a better image quality, adding ES bone images to standard radiographs of the chest does not provide better sensitivity or improved diagnostic confidence in the detection of rib fractures.     

DDR骨组织像与核素骨显像诊断肿瘤患者肋骨病变的对照研究

目的：比较能量减影（DE）骨组织像与核素骨显像对肿瘤患者肋骨病变的诊断价值。材料和方法：对48例核素骨显像检查发现肋骨病变的肿瘤患者，再行DE骨组织像判定其性质（转移性或非转移性）。结果：48例患者中，核素骨显像考虑转移性28例（54．2％），非转移性20例（45．8％）。DE骨组织像发现肋骨病变36例（75．0％），无肋骨病变12例（25．0％）；有肋骨病变36例中，转移性26例（72．2％），非转移性10例（27．8％）。核素骨显像与DE骨组织像对肋骨病变的检出率有高度统计学意义（P〈0．01），DE骨组织像与核素骨显像对肋骨病变的真阳性率有高度统计学意义（P〈0．01），DE骨组织像与核素骨显像对肋骨病变的假阴性率有统计学意义（P〈0．05）。结论：肿瘤患者肋骨病变DE骨组织像的真阳性率和假阴性率高于核素骨显像，而检出率核素骨显像高于DE骨组织像，核素骨显像对发现肋骨早期病变的价值明显。     

低剂量与常规剂量对比剂双能量肺灌注图像质量对比分析

目的:探讨对比剂剂量对双源CT双能量肺灌注成像质量的影响.方法:疑肺动脉栓塞患者行双源CT双能量肺灌注扫描,30例使用低剂量(0.7ml/kg)对比剂,30例使用常规剂量对比剂(1.5ml/kg),注射速率均为4.5ml/s.扫描后同时获得肺动脉CTA及肺灌注图像.测量左、右叶肺动脉干及各肺叶动脉增强后的CT值,对比分析两组间增强后的CT值.判断肺灌注图像质量并分级,比较两组的肺灌注图像质量差异.结果:低剂量组与常规剂量组左、右叶肺动脉干及各肺叶动脉增强后的CT值无明显差异(P＞0.05).肺段及亚段肺动脉图像清晰显示.低剂量组肺灌注图像大部分信号均匀(26/30),常规剂量组肺灌注图像大部分信号均匀(24/30).常规剂量组上腔静脉、右心房高密度对比剂所致灌注伪影明显多于低剂量组(48:10).结论:低剂量与常规剂量双能量肺灌注成像的肺动脉图像质量无明显差异,降低对比剂剂量可以减少双能量肺灌注图像的伪影.     

Clinical results of CsI-detector-based dual-exposure dual energy in chest radiography

The aim of this study was to compare the sensitivity and specificity of digital chest radiography alone with digital chest radiography combined with dual-energy chest radiography in the detection of small non-calcified pulmonary nodules. Standard and dual-energy radiographs were obtained with a flat-panel digital chest system. Four radiologists reviewed digital posteroanterior chest radiographs in random order either alone or in conjunction with dual-energy soft tissue and bone images. Twenty patients with a total of 59 pulmonary nodules (median 0.5 cm, range 0.3 – 2.5 cm) confirmed by computed tomography (HU 100) were included. A level of confidence for each diagnosis was documented using a rating scale of 1–5. Brunner and Langer's test was performed for statistical analysis. Subgroup analysis was performed for nodules greater than 1 cm, 1–0.5 cm, and <0.5 cm. For posteroanterior chest radiography, sensitivity was 33%, positive predictive value 83%, specificity 81%, and negative predictive value 30%. Review in conjunction with dual-energy images resulted in a sensitivity of 42%, positive predictive value 88%, specificity 85%, and negative predictive value 34%. The increase of nodule detection overall as well as for different size categories was significant (p<0.05). The increase of the confidence level rating was also significant (p<0.001). Dual energy added to standard posteroanterior chest radiography significantly improves the sensitivity, specificity, and confidence in detection of small non-calcified pulmonary nodules.     

CsI-detector-based dual-exposure dual energy in chest radiography for lung nodule detection: results of an international multicenter trial

To assess both sensitivity and specificity of digital chest radiography alone and in conjunction with dual-exposure dual-energy chest radiography for the detection and classification of pulmonary nodules. One hundred patients with a total of 149 lung nodules (3-45 mm; median, 11 mm) confirmed by CT were included in this study. Dual-exposure dual-energy chest radiographies of each patient were obtained using a CsI detector system. Experienced board-certified chest radiologists from four different medical centers in Europe reviewed standard chest radiographs alone and in conjunction with dual-energy images blinded and in random order. The reviewers rated the probability of presence, calcification and malignancy of all lung nodules on a five-point rating scale. Lesions detected were identified by applying a specific coordinate system to enable precise verification by the study leader. A receiver-operating characteristic (ROC) analysis was performed. In addition to the 149 true-positive CT proven lesions, 236 false-positive lung nodules were described in digital chest radiographies in conjunction with dual-energy chest radiographies. The cumulative sensitivity of chest radiography in conjunction with dual energy was 43%, specificity was 55%. For digital radiography alone, sensitivity was 35% and specifity was 83%. For the dual energy system, positive predictive value was 58%, and negative predictive value was 66% compared to the digital radiography with a positive predictive value of 59% and a negative predictive value of 65%. Areas under the curve in a ROC analysis resulted in 0.631 (95% confidence interval =0.61 to 0.65) for radiography with dual energy and 0.602 (95% confidence interval =0.58 to 0.63) for digital radiography alone. This difference was not statistically significant. For the detection of lesion calcification or the determination of malignancy, ROC analysis also failed to show significant differences. CsI-based flat-panel dual-exposure dual-energy imaging added to standard chest radiography did not show statistically significant improvement for the detection of pulmonary nodules, nor the identification of calcifications, nor the determination of malignancy.     

计算机X线摄影能量减影与直接数字摄影对胸部软组织病变检测能力比较

目的 比较计算机X线摄影能量减影技术(ES-CR)与直接数字摄影技术(DR)对肺内软组织信号的探测能力。方法 应用胸部放射学体模和X线摄影统计学体模摄取ES-CR和DR影像,由6位放射科医师用5等级判别法各自独立阅读影像,编写程序对观察结果进行受试者操作特性曲线(ROC)分析。收集28例病理证实小肺癌患者的胸部DR影像和ES-CR影像,由3位放射科医师一起做出诊断,分析其真阳性率的差异性。结果 体模影像的ROC分析,ES-CR和DR的 Az 值分别为0.727和0.827,差异有统计学意义( Z =2.96, P<0.05)。28例小肺癌两成像系统的差异也有统计学意义(χ²=5.14, P<0.05)。结论 用DR诊断的真阳性率要高于ES-CR。ES-CR对胸部软组织信号的检出能力尚不如DR。