肝脏门静脉期CT增强的影响因素与对策

随着CT技术的发展,尤其是近几年双能CT的出现,不仅提高了影像质量,而且能够实现物质定量分析,极大拓展了临床应用范围,但同时也对优化应用提出了新的挑战。在上腹部检查中由于肝脏双重供血的特点造成了增强检查的特殊性,这突出体现在门静脉期影像质量难以达到预期而降低诊断可靠性上。因此,分析影响门静脉期增强的对比剂、病人和CT扫描等方面因素,总结在提高影像质量的同时降低对比剂剂量和辐射剂量的研究进展,并展望基于双能CT的个性化的上腹部增强检查计划设计方案。

Contrast enhancement of abdominal CT at portal venous phase:considerations and solutions

With the continuing development of computed tomographic（ＣＴ） technology, especially dual-energy CT （DECT）, new clinical applications has been discovered based on the capability of material decomposition and improved image quality accordingly. Innovative CT technology has introduced new challenges in optimization of clinical radiology practice in return. One of the challenges is with contrast enhancement of upper abdominal CT at portal venous phase which is difficult to optimize due to the double blood supply. In this article, contrast medium, patient and CT scanning factors associated with contrast enhancement at portal venous phase were addressed and discussed. Published studies on improving image quality while reducing contrast medium dose and radiation dose were reviewed and interpreted. A new paradigm of individualized examination planning system based on dual-energy CT to optimize contrast medium administration and scanning protocol was proposed.