CAJ | 학술논문

目的：宝石能谱 CT 肺动脉造影使用低对比剂量的可行性研究。方法前瞻性连续选择疑似肺动脉栓塞的患者48例行多层螺旋 CT 肺动脉造影检查。按检查奇偶数分为 A、B 2组。分别为 A 组24例：使用宝石能谱 CT 结合35 mL 对比剂量进行检查；B 组24例：使用64排多层螺旋 CT 结合常规对比剂量80~90 mL 进行检查。2组图像分别测量肺动脉主干、亚段级肺动脉、肺静脉、升主动脉的 CT 值。计算出肺动脉的对比噪声比(CNR)进行客观影像评价。由2名资深影像学医师以5分制对2组多层螺旋 CT 肺动脉造影的图像质量进行评分。结果图像客观评价：A 组图像肺动脉主干 CT 值、亚段级肺动脉 CT 值、CNR 均明显高于 B 组，经独立样本 t 检验，均有统计学意义(t=8.6、P <0.001；t=12.2、P <0.001；t=11.3、P <0.001)；A 组主动脉 CT 值明显低于 B 组，有统计学意义(t=-7.6、P <0.001)。图像主观评价：医师Ⅰ、医师Ⅱ对 A、B 2组图像质量评估均有显著统计学意义(Z =-8.6、P <0.001；Z =-9.0、P <0.001)。A 组图像质量明显好于 B 组。结论宝石能谱 CT 低对比剂量肺动脉造影与常规螺旋CT 肺动脉造影相比较图像质量得到大幅提高。
목적：보석능보 CT 폐동맥조영사용저대비제량적가행성연구。방법전첨성련속선택의사폐동맥전새적환자48례행다층라선 CT 폐동맥조영검사。안검사기우수분위 A、B 2조。분별위 A 조24례：사용보석능보 CT 결합35 mL 대비제량진행검사；B 조24례：사용64배다층라선 CT 결합상규대비제량80~90 mL 진행검사。2조도상분별측량폐동맥주간、아단급폐동맥、폐정맥、승주동맥적 CT 치。계산출폐동맥적대비조성비(CNR)진행객관영상평개。유2명자심영상학의사이5분제대2조다층라선 CT 폐동맥조영적도상질량진행평분。결과도상객관평개：A 조도상폐동맥주간 CT 치、아단급폐동맥 CT 치、CNR 균명현고우 B 조，경독립양본 t 검험，균유통계학의의(t=8.6、P <0.001；t=12.2、P <0.001；t=11.3、P <0.001)；A 조주동맥 CT 치명현저우 B 조，유통계학의의(t=-7.6、P <0.001)。도상주관평개：의사Ⅰ、의사Ⅱ대 A、B 2조도상질량평고균유현저통계학의의(Z =-8.6、P <0.001；Z =-9.0、P <0.001)。A 조도상질량명현호우 B 조。결론보석능보 CT 저대비제량폐동맥조영여상규라선CT 폐동맥조영상비교도상질량득도대폭제고。
Objective To probe the feasibility of gemstone spectral CT in imaging pulmonary angiography with low dose contrast medium.Methods A prospective study with multi-slice spiral CT pulmonary angiography was performed in consecutive 48 patients suspected with pulmonary embolism.Two groups (n=24 respectively)were divided at random including Group A used Gemstone spectral CT with 35 mL of contrast medium and Group B using 64-slice CT with conventional 80~90 mL of contrast medium.The CT values of the pulmonary trunk,lobe artery,pulmonary vein and ascending aorta were measured.The contrast to noise ratio of the pulmonary artery was also calculated.In addition,the image quality of CTA was evaluated independently by two experienced ra-diologists.Results The CT values of the pulmonary trunk and the subsegmental branches,and the CNR in Group A were signifi-cantly higher than those in group B,exhibiting statistical differences (t=8.6,P <0.001;t=12.2,P <0.001;t=1 1.3,P <0.001 respectively).However,the CT value of aorta in Group A was significantly lower than that in Group B (t=-7.6,P <0.001).The evaluation results of the CTA images by two radiologists showed that the image quality in Group A was better than that in Group B (Z =-8.6,P <0.001;Z =-9.0,P <0.001 ).Conclusion The image quality of pulmonary angiography with gemstone spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.