直接数字化成像双能量减影技术的临床适应症

目的探讨直接数字化成像（digital radiography,DR）中双能量减影技术（dual energy subtraction,DES）的应用价值和意义。方法在病人自愿、病情需要的情况下,对79例病人的鼻咽部、喉部、气管、胸部及腹部（含胆系、泌尿系及消化系）等部位做DES检查。由3名以上有经验的医师共同进行阅片,比较分析标准片、减影后软组织片及骨片组织片,对病变进行比较性诊断。结果接受鼻咽部DES检查者8例,5例显示病变;胸部46例中,检出阳性45例;腹部10例中,检出阳性8例;气管10例、胸腰椎10例均检出阳性;5例阴性患者的CT结果为阳性。静脉肾盂造影和胆系T管造影各2例,为对正常人的尝试性检查。结论双能量减影主要适用于骨骼、咽喉部、气管及肺部病变微小结节性病灶,并为疾病的鉴别诊断提供帮助,对腹部与鼻咽部检查优于平片。但造影中应用DES无明确临床意义。

Clinical Indications of Dual-energy Subtraction in Digital Radiography

Objective To evaluate the application value and signification of digital radiography(DR) dual energy subtraction.Methods A total of 79 voluntary patients accepted DR dual energy subtraction examination when necessary on nasal pharynx,laryngeal,laceration,chest and abdomen(including biliary,urinar and,digestive systems).By joint film reading of three or more experienced physicians,a comparative analysis of standard films,soft tissue films and bone tissue films was performed,and differential diagnosis was conducted.Results In 8 cases with nasopharynx examination,5 cases were positive.In 46 cases with chest examination,45 cases were positive.In 10 cases with abdomen examination,8 cases were positive.All 10 cases with trachea examination and 10 cases with thoracic and lumbar spine examination had positive manifestations.Five patients with negative DES results had positive CT results.Besides,intravenous urography and biliary T tube angiography were tried on two normal cases respectively.Conclusion Dual-energy subtraction is applicable to small nodular lesions in bone,throat,trachea and lung,available for the differential diagnosis,and better than plain film in abdomen and the nasopharynx examination.But the application of DES has no explicit clinical significance.