Citation: | WANG X, LU X P, ZHANG P, et al. Evaluation of the Optimizing Value of Dual-Energy Computed Tomography Mixed Images Combined with a 3 mL/s Contrast Agent Injection Rate in Reducing Contrast Agent Artifacts in the Axillary Vein Area during Chest and Abdomen Contrast-Enhanced Imaging[J]. CT Theory and Applications, xxxx, x(x): 1-9. DOI: 10.15953/j.ctta.2024.333. (in Chinese). |
Objective: To evaluate the clinical application value of dual-energy computed tomography (DECT) combined with a 3 mL/s contrast agent injection rate in comparison with single-energy CT (SECT) using a 2.5 mL/s injection rate by comparing the sizes of contrast agent artifacts in the axillary vein during the arterial phase of chest and abdomen enhanced CT examinations. Methods: A retrospective study was conducted on 77 cases of chest and abdomen enhanced CT scans that were performed from January to November 2024 at our hospital. These scans were performed on the same subjects using both dual-energy (experimental group) and single-energy (control group) CT techniques. The differences between the two groups were compared in terms of axillary vein contrast agent artifact size, arterial phase enhancement, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), subjective evaluations of artifact severity, and overall image quality. The subjective evaluations of artifact severity and image quality were independently assessed by two radiologists. Results: The subjective and objective scores for axillary vein contrast agent artifacts in the experimental group were significantly lower than those in the control group. The arterial CT values in the experimental group were higher than those in the control group. The SNR and CNR in non-artifact-affected regions, such as bone, muscle, and adipose tissue, in the experimental group were not lower than those in the control group, whereas the radiation dose was significantly lower in the experimental group. The subjective scores for artifact severity were better in the experimental group, and the subjective image quality scores in the experimental group were superior to those in the control group. The interobserver agreement between the two radiologists was high. Conclusion: Dual-energy CT combined with a 3.0 mL/s contrast agent injection rate significantly reduces contrast agent artifacts in the axillary vein, improves image quality, and lowers the radiation dose, compared with single-energy CT with a 2.5 mL/s injection rate, demonstrating a better clinical application value in chest and abdomen enhanced CT examinations.
[1] |
裴锦奎, 刘豪, 张进慧, 等. 肺动脉CTA联合腹部增强CT的一站式能谱扫描在妇科肿瘤患者术前评估中的价值[J]. 中国临床医学, 2024, 31(5): 795-803. DOI: 10.12025/j.issn.1008-6358.2024.20240615.
PEI J K, LIU H, ZHANG J H, et al. Value of one-stop spectral scanning of computer tomography pulmonaryangiography combined with abdominal-pelvic enhancement in the pre-operative evaluation for patients with gynecologic tumors[J]. Chin J Clin Med, 2024, 31(5): 795-803. DOI: 10.12025/j.issn.1008-6358.2024.20240615. (in Chinese).
|
[2] |
PARK C, GRUBER-ROUH T, LEITHNER D, et al. Single-source chest-abdomen-pelvis cancer staging on a third generation dual-source CT system: comparison of automated tube potential selection to second generation dual-source CT[J]. Cancer Imaging: the official publication of the International Cancer Imaging Society, 2016, 16(1): 33. DOI: 10.1186/s40644-016-0093-1.
|
[3] |
朱晓霞, 李铭, 金倞, 等. 肺癌患者胸腹联合增强CT扫描方案的优化研究[J]. 放射学实践, 2019, 34(02): 147-151. DOI: 10.13609/j.cnki.1000-0313.2019.02.007.
ZHU X X, LI M, JIN J, et al. Research on scanning protocal optimization of the chest, abdomen and pelvis combined enhanced CT in patients with lung cancer[J]. Radiologic Practice, 2019, 34(02): 147-151. DOI: 10.13609/j.cnki.1000-0313.2019.02.007.
|
[4] |
赵海波. 胸腹部CT联合增强扫描方式分析[J]. 北京生物医学工程, 2013, 32(02): 198-200. DOI: 10.3969/j.issn.1002-3208.2013.02.18.
ZHAO H B. Scanning mode in enhanced CT of the chest and abdomen[J]. Beijing Biomedical Engineering, 2013, 32(02): 198-200. DOI: 10.3969/j.issn.1002-3208.2013.02.18.
|
[5] |
曹希明, 郑君惠, 巫梓斌, 等. 低剂量对比剂在256层CT头颈血管成像中的应用[J]. 中国医学影像学杂志, 2017, 25(02): 101-104. DOI: 10.3969/j.issn.1005-5185.2017.02.006.
CAO X M, ZHENG J H, WU Z B, et al. Application of Low-dose Contrast Agent in 256-slice CT Angiography for Head-and-neck[J]. Chinese Journal of Medical Imaging, 2017, 25(02): 101-104. DOI: 10.3969/j.issn.1005-5185.2017.02.006.
|
[6] |
陈瑜凤, 夏淦林, 李洪江, 等. 64层螺旋CT胸腹联合增强扫描显示肺动脉相关病变及肺癌支气管动脉的应用价值[J]. 中国CT和MRI杂志, 2013, 11(6): 44-47,65. DOI: 10.3969/j.issn.1672-5131.2013.06.013.
CHEN Y F, XIA G L, LI H J, et al. Application Showing the Pulmonary Artery Related Lesionsand Lung Cancer Bronchial Artery by Thoracoabdominal Enhanced Scan of 64-Slice CT[J]. Chinese Journal of CT andMRI, 2013, 11(6): 44-47,65. DOI: 10.3969/j.issn.1672-5131.2013.06.013.
|
[7] |
董相宇, 方挺松, 袁健祥, 等. 基于BSA及固定碘速率探讨不同浓度对比剂对肝静脉CT成像效果的影响[J]. CT理论与 应用研究, 2021, 30(4): 466-476. DOI: 10.15953/j.1004-4140.2021.30.04.07.
DONG X Y, FANG T S, YUAN J X, et al. Discussion on the Effect of Different Concentrations of Contrast Media on CT Imaging of Hepatic Veins Based on BSA and Fixed Iodine Rate[J]. ComputedTomography Theory and Applications, 2021, 30(4): 466-476. DOI: 10.15953/j.1004-4140.2021.30.04.07.
|
[8] |
吴建峰, 李林静, 方春, 等. 个体化碘对比剂注射速率方案在肝脏增强CT中提高增强质量一致性的价值[J]. 中国医师 杂志, 2022, 24(3): 3. DOI: 10.3760/cma.j.cn431274-20210518-00556.
|
[9] |
KANG M J, PARK C M, LEE C H, et, al. Focal iodine defects on color-coded iodine perfusion maps of dual- energy pulmonary CT angiography images: a potential diagnostic pitfall. AJR Am J Roentgenol. 2010 Nov; 195(5): W325-30. DOI: 10.2214/AJR.09.3241.
|
[10] |
BARRETT J F, KEAT N. Artifacts in CT: recognition and avoidance. Radiographics. 2004 Nov-Dec;24(6): 16 79-91. DOI: 10.1148/rg.246045065.
|
[11] |
KALISZ K, BUETHE J, SABOO S S, et al. Artifacts at Cardiac CT: Physics and Solutions. Radiographics. 20 16 Nov-Dec;36(7): 2064-2083. DOI:10.1148/rg.2016160079.Epub 2016 Oct 21.
|
[12] |
苗彦, 张天瑞, 袁涛, 等. 双能CT虚拟单能技术在CT血管成像中的应用进展[J]. 国际医学放射学杂志, 2024, 47(05): 582-587+609. DOI: 10.19300/j.2024.Z21310.
MIAO Y, ZHANG T R, YUAN T, et al. Application advances of dual energy CT virtualmonoenergetic imaging in CT angiography[J]. International Journal of Medical Radiology, 2024, 47(05): 582-587+609. DOI: 10.19300/j.2024.Z21310. (in Chinese).
|
[13] |
MILETO A, ANANTHAKRISHNAN L, MORGAN D E, et al. Clinical Implementation of Dual-Energy CT for Gastroi ntestinal Imaging[J]. American Roentgen Ray Society, 2021(3). DOI: 10.2214/AJR.20.25093.
|
[14] |
熊祖坤, 付晓伟, 吕律, 等. 能谱CT技术去除胸部增强CT扫描患者腋静脉和锁骨下静脉对比剂伪影[J]. 中华放射学 杂志, 2016(11): 4. DOI: 10.3760/cma.j.issn.1005-1201.2016.11.004.
XIONG Z K, FU X W, LV L, et al. The application research of spectral CT for reducing beam-hardening artifacts around axillary vein and subclavian vein due to the utility of contrast agent in the chest enhanced CT scan[J]. Chinese Journal of Radiology, 2016(11): 4. DOI: 10.3760/cma.j.issn.1005-1201.2016.11.004.
|
[15] |
潘南南, 王硕, 李文贵. 能谱CT单能量技术去除胸部增强对比剂伪影的价值[J]. 医学理论与实践, 2020, 33(21): 4. DOI: 10.19381/j.issn.1001-7585.2020.21.006.
PAN N N, WANG S, LI W G. Role of virtual monoenergetic images from spectral detector CT inreducing artifacts from contrast media in enhanced chest CT[J]. The Journal of Medical Theory and Practice, 2020, 33(21): 4. DOI: 10.19381/j.issn.1001-7585.2020.21.006.
|
[16] |
CHERRY K, DAJUNG K, YEOL L K, et al. The Optimal Energy Level of Virtual Monochromatic Images From Sp ectral CT for Reducing Beam-Hardening Artifacts Due to Contrast Media in the Thorax[J]. Ajr Americ an Journal of Roentgenology, 2018: 1. DOI: 10.2214/AJR.17.19377.
|
[17] |
WANG X, ZHENG F, XIAO R, et al. Comparison of image quality and lesion diagnosis in abdominopelvic u nenhanced CT between reduced-dose CT using deep learning post-processing and standard-dose CT usin g iterative reconstruction: A prospective study[J]. European Journal of Radiology, 2021, 139: 109735. DOI: 10.1016/j.ejrad.2021.109735.
|
[18] |
BAE KT. Intravenous contrast medium administration and scan timing at CT: considerations and approa ches[J]. Radiology, 2010, 256(1): 32-61. DOI: 10.1148/radiol.10090908.
|
[19] |
JOHNSON T R, KRAUSS B, SEDLMAIR M, et al. Material differentiation by dual energy CT: initial experien ce[J]. European Radiology, 2007, 17(6): 1510-1517. DOI: 10.1007/s00330-006-0517-6.
|
[20] |
LAMB P, SAHANI D V, FUENTES-ORREGO J M, et al. Stratification of patients with liver fibrosis using d ual-energy CT[J]. IEEE Transactions on Medical Imaging, 2015, 34(3): 807-815. DOI: 10.1109/TMI.2014.2353044.
|
[21] |
陈琳钰, 方姝, 陈勇, 等. 虚拟单能图像与常规CT图像的图像质量对比[J]. CT理论与应用研究, 2022, 31(02): 219-226. DOI: 10.15953/j.ctta.2021.041.
CHEN L Y, FANG S, CHEN Y, et al. Comparison of image quality between virtual monochromatic images and conventional CT images[J]. Computed Tomography Theory and Applications, 2022, 31(02): 219-226. DOI: 10.15953/j.ctta.2021.041.
|
[22] |
LENGA L, TRAPP F, ALBRECHT M H, WICHMANN J L, et al. Single and dual-energy CT pulmonary angiography u sing second-and third-generation dual-source CT systems: comparison of radiation dose and image qua lity. Eur Radiol. 2019 Sep;29(9): 4603-4612. DOI: 10.1007/s00330-018-5982-1.
|