双能量CT虚拟平扫代替真实平扫用于降低克罗恩病小肠造影辐射剂量

武鹏飞; 李大鹏; 王传兵; 江月

doi:10.15953/j.ctta.2024.342

双能量CT虚拟平扫代替真实平扫用于降低克罗恩病小肠造影辐射剂量

1.
南京医科大学第一附属医院放射科，南京 210029
2.
南京医科大学附属老年医院，南京 210029

详细信息

作者简介:
武鹏飞，男，研究生在读，研究方向为CT成像技术，E-mail：85460024 @qq.com

通讯作者:
江月✉，女，副主任技师，E-mail：176168376@qq.com。

中图分类号: R 445
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- 文章访问数: 20
- HTML全文浏览量: 5
- PDF下载量: 4
出版历程
- 收稿日期: 2024-12-30
- 修回日期: 2025-02-28
- 录用日期: 2025-03-02
- 网络出版日期: 2025-03-15

Dual-Energy CT Virtual Non-Contrast as a Low-Radiation Alternative to True Non-Contrast in Crohn’s Disease Enterography

1.
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
2.
Affiliated Geriatric Hospital of Nanjing Medical University, Nanjing 210029, China

摘要

摘要:
目的：探讨双能量CT虚拟平扫代替真实平扫用于降低克罗恩病小肠造影辐射剂量的应用价值。方法：获取2024年6月至2024年12月在南京医科大学第一附属医院53例克罗恩病患者双能量小肠造影图像，利用双能量分析软件重建获得动脉期和静脉期的虚拟平扫图像，采用单因素方差分析对常规平扫和动静脉期虚拟平扫图像的CT值、SNR、CNR进行评价；采用5分法对图像质量进行主观评价，并采用秩和检验分析。结果：TNC、VNCa及VNCv的图像质量主观评分分别为4（4，5）、4（4，5）、4（4，5），且差异不具有统计学意义。TNC、VNCa及VNCv之间，病变肠壁、正常肠壁、下腔静脉、竖脊肌、肝脏的CT值差异不具有统计学意义。病变肠壁、正常肠壁、腹主动脉、下腔静脉、肝脏的SNR值差异具有统计学意义且VNCa及VNCv的SNR值均高于TNC。病变肠壁、正常肠壁、下腔静脉、肝脏的CNR值差异不具有统计学意义。VNCv较TNV CTE扫描的辐射剂量大约降低了30%。结论：双能量CT虚拟平扫代替真实平扫在保证图像质量的同时可以降低克罗恩病小肠造影辐射剂量，可以在临床应用中推广。
- 辐射剂量 /
- 虚拟平扫 /
- 小肠造影 /
- 克罗恩病
Abstract:
Objective: To investigate the value of dual-energy computed tomography (CT) virtual plain scans in reducing the radiation dose of small intestine angiography for Background: Crohn’s disease enterography tends to involve multiple computed tomography (CT) scans, which can expose patients to more radiation and additional complications. This study evaluates the feasibility of using dual-energy CT virtual non-contrast (VNC) imaging as a low-radiation alternative to true non-contrast (TNC) imaging. Methods: Dual-energy small-bowel imaging was performed on 53 patients with Crohn’s condition at the First Affiliated Hospital of Nanjing Medical University from June 2024 to December 2024. Virtual normal scan images of the arterial (VNCa) and venous phases (VNCv) were reconstructed using dual-energy analysis software. CT values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the conventional and virtual plain scans were analyzed using one-way ANOVA. Image quality was evaluated subjectively using a five-point grading system and analyzed with the rank sum test. Results: The subjective scores of the TNC, VNCa, and VNCv were 4 (4, 5), 4 (4, 5), and 4 (4, 5), with no statistically significant differences. The CT values of the pathological intestinal wall, normal intestinal wall, inferior vena cava, erector spinae muscle, and liver showed no significant differences among TNC, VNCa, and VNCv. SNR values of the pathological intestinal wall, normal intestinal wall, abdominal aorta, inferior vena cava, and liver were significantly higher in VNCa and VNCv than in TNC. There were no significant differences observed in the CNR values across the groups. The radiation dose of the VNCv was approximately 30% lower than that of the TNV CT enterography scan. Conclusion: A dual-energy CT virtual plain scan, rather than an actual plain scan, can reduce the radiation dose of Crohn’s disease enterography without compromising the image quality. This approach has the potential for extensive clinical applications.
- radiation dose /
- virtual non-contrast /
- enterography /
- Crohn’s disease

HTML全文

图 1 男，34岁，克罗恩病，ROI测量示意图

注：（a）为一克罗恩病患者病变层面轴位图像；（b）为病变肠壁ROI测量示意图，ROI测量面积约为8 mm²；（c）为正常肠壁ROI测量示意图，ROI测量面积约为2 mm²。

Figure 1. Male, 34 years old, Crohn’s disease (CD), ROI measurement diagram

下载: 全尺寸图片幻灯片

图 2 女，28岁，克罗恩病

注：（a）（d）分别是TNC轴位和重组冠状位图，显示末端回肠节段性肠壁增厚（白色箭头）；（b）（e）分别是VNCa轴位和重组冠状位图；（c）（f）分别是TNCv轴位和重组冠状位图均可见相同位置及范围的肠壁增厚。

Figure 2. 28-year-old female with Crohn’s disease（CD）

下载: 全尺寸图片幻灯片

表 1 TNC、VNCa及VNCv的图像质量主观评分

Table 1 Subjective image quality scores for TNC, VNCa and VNCv

组别	TNC	VNCa	VNCv	P
医师甲	4（4，5）	4（4，5）	4（4，5）	> 0.05
医师乙	4（4，5）	4（4，5）	4（4，5）	> 0 05
Kappa值	0. 732	0. 688	0. 774

下载: 导出CSV

表 2 TNC、VNCa及VNCv图像CT值（HU）的结果比较

Table 2 Comparison of CT values (HU) of TNC, VNCa and VNCv

	组别			统计检验
	TNC	VNCa	VNCv	F	P
病变肠壁	38. 55±1.94	39. 22±3.63	38. 88±3.01	0.103	0.902
正常肠壁	25. 89±1.69	26. 01±3.93	25. 98±3.39	0.004	0.996
腹主动脉	47. 02±7.21	78. 11±8.97	52. 77±8.29	36.73	< 0.001
下腔静脉	41. 44±6.29	43. 11±8.93	49. 44±9.41	2.314	0.121
竖脊肌	54. 67±5.89	53. 55±6.48	58. 67±9.16	1.217	0.315
肝脏	51. 89±7.68	62. 22±10.55	61. 55±15.51	2.196	0.133

下载: 导出CSV

表 3 TNC、VNCa及VNCv SNR的结果比较

Table 3 Comparison of SNR results for TNC, VNCa and VNCv

	组别			统计检验
	SNRTNC	SNRVNCa	SNRVNCv	F	P
病变肠壁	2.36±0.36	3.23±0.58	3.14±0.76	5.923	0.008
正常肠壁	1.58±0.24	2.13±0.35	2.01±0.49	5.895	0.009
腹主动脉	2.91±0.69	6.58±1.93	4.26±1.13	16.940	< 0.001
下腔静脉	2.56±0.59	3.55±0.89	3.92±0.84	7.241	0.003
竖脊肌	3.36±0.67	4.49±1.31	4.26±2.11	2.636	0.092
肝脏	3.21±0.75	5.31±1.82	5.08±2.06	4.396	0.024

下载: 导出CSV

表 4 TNC、VNCa及VNCv图像CNR的结果比较

Table 4 Comparison of CNR results of TNC, VNCa and VNCv image

	组别			统计检验
	CNRTNC	CNRVNCa	CNRVNCv	F	P
病变肠壁	1.01±0.43	1.26±0.94	1.78±1.45	1.348	0.279
正常肠壁	1.77±0.51	2.37±1.16	2.83±1.71	1.655	0.212
腹主动脉	0.46±0.54	2.09±1.15	0.66±1.45	16.905	0.001
下腔静脉	0.81±0.41	0.94±1.32	0.99±1.77	0.051	0.951
肝脏	0.15±0.49	0.81±0.99	0.16±1.11	2.637	0.092

下载: 导出CSV

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