基于上腹部CT动态容积灌注扫描行动脉、门静脉及肾静脉三维融合成像

目的观察基于CT动态容积灌注(DVPCT)扫描行上腹部动脉、门静脉及肾静脉三维融合成像的可行性。方法前瞻性纳入25例上腹部肿瘤患者为试验组、22例其他患者为对照组,行上腹部DVPCT扫描,对试验组腹主动脉、门静脉和肾静脉强化峰值起始处至结束处所有图像行融合重建和容积再现(VR),对照组行上腹部动脉早期、动脉晚期及门静脉期扫描;对比组间各血管信噪比(SNR)、对比度噪声比(CNR)、图像质量评分及其质量合格率差异,观察DVPCT动静脉融合成像的效果。结果试验组各血管SNR及CNR均高于对照组(P均<0.001)。试验组肝右动脉及第一空肠动脉评分均低于对照组(P均<0.05),脾静脉、门静脉主干、门静脉左支、门静脉右支及左、右肾静脉评分均高于对照组(P均<0.05),而其质量合格率均无明显组间差异(P均>0.05);胃左静脉评分及合格率均高于对照组(P均<0.05),肠系膜下静脉评分及合格率均低于对照组(P均<0.05)。观察者间测量试验组腹腔干SNR的一致性中等(ICC=0.73,P<0.05),对其余各血管SNR及CNR的一致性均好(ICC均≥0.75,P均<0.05);对第一空肠静脉及胃结肠干评分的一致性中等(Kappa=0.72、0.74,P均<0.05),对其余各血管评分的一致性均好(Kappa均≥0.75,P均<0.05)。结论基于DVPCT扫描可较好地实现上腹部动脉、门静脉及肾静脉三维融合成像。

Three-dimensional fusion imaging of arteries, portal veins and renal veins based on upper abdominal dynamic volume perfusion CT

Objective To observe the feasibility of three-dimensional fusion imaging of arteries,portal veins and renal veins based on upper abdominal dynamic volume perfusion CT(DVPCT).Methods Twenty-five patients with upper abdominal tumors were prospectively enrolled(experimental group),and the images from the beginning to the end of the enhancement peak of abdominal aorta,portal vein and renal vein obtained with upper abdominal DVPCT were extracted for post-processing of fusion reconstruction and volume rendering(VR).Meanwhile,22 patients who underwent early arterial phase,late arterial phase and portal venous phase(PVP)scanning and post-processing of VR were randomly selected as control group.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),image quality score and quality qualification rate of upper abdominal vessels were observed and compared between groups.The effect of DVPCT arteriovenous fusion imaging was analyzed.Results SNR and CNR of blood vessels of experimental group were higher than those of control group(all P<0.001).The scores of right hepatic artery and first jejunal artery of experimental group were lower than those of control group(both P<0.05),and the scores of splenic vein,main portal vein,left portal vein,right portal vein,left and right renal vein were higher than those of control group(all P<0.05),while there was no significant difference of qualification rates of the above vessels between groups(all P>0.05).The score and qualification rate of left gastric vein of experimental group were higher than those of control group(both P<0.05),while the score and qualification rate of inferior mesenteric vein were lower than those of control group(both P<0.05).In experimental group,the intra-observer consistency of SNR of celiac trunk measured was general(ICC=0.73,P<0.05),while of SNR and CNR of other blood vessels were all good(all ICC≥0.75,all P<0.05).The intra-observer consistency of scores of first jejunal vein and gastrocolic trunk graded was both general(Kappa=0.72,0.74,both P<0.05),and of other blood vessels were good(all Kappa≥0.75,all P<0.05).Conclusion Three-dimensional fusion imaging of upper abdominal arteries,portal veins and renal veins could be achieved based on DVPCT.