中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2014年
7期
594-598
,共5页
刘文冬%吴兴旺%刘斌%李红文%王斌
劉文鼕%吳興旺%劉斌%李紅文%王斌
류문동%오흥왕%류빈%리홍문%왕빈
胃肠出血%体层摄影术,X线计算机%能谱成像
胃腸齣血%體層攝影術,X線計算機%能譜成像
위장출혈%체층섭영술,X선계산궤%능보성상
Gastrointestinal hemorrhage%Tomography,X-ray computed%Spectral imaging
目的 探讨能谱CT单能量成像诊断小肠活动性出血的价值,以及显示肠道活动性出血的最佳单能量值.方法 离体猪小肠和微量注射器连接,分别设置7种注射流率(分别为0.500、0.400、0.300、0.200、0.100、0.050、0.025 ml/min)模拟活动性小肠出血.分别对上述模型进行普通模式及能谱成像(GSI)模式扫描,每个流率扫描5次.延迟15、40 s扫描分别模拟动脉期和门静脉期.普通模式扫描得到混合能量图像,对GSI模式扫描图像进行重建得到40、50、60、70、80、90和100 keV共7种单能量图像.观察不同扫描模式和期相图像的对比噪声比(CNR),同时记录不同扫描模式下对比剂渗出的检出结果.对不同期相和扫描模式图像的CNR比较采用方差分析,对比剂渗出检出情况的比较采用x2检验.结果 动脉期,普通模式和GSI模式对比剂渗出的检出情况(分别为23/35和31/35)差异有统计学意义(x2=5.185,P=0.023);门静脉期,2种模式的检出情况(分别为32/35和35/35)差异无统计学意义(x2=1.393,P=0.238).普通模式下,动脉期和门静脉期的检出情况差异有统计学意义(x2=6.873,P=0.009); GSI模式下,动脉期和门静脉期检出情况差异无统计学意义(x2=2.386,P=0.122).动脉期和门静脉期,8组能量图像CNR差异均有统计学意义(P均＜0.05),GSI模式50和60 keV单能量图像对比剂渗出区的CNR值高于混合能量图像,差异有统计学意义(P均＜0.05),各能量组门静脉期图像CNR均高于动脉期像,差异均有统计学意义(t值为-3.996～-2.380,P均＜0.05).结论 能谱CT单能量成像诊断小肠活动性出血的价值优于普通CT,最佳单能量值为50、60 keV,且门静脉期优于动脉期.
目的 探討能譜CT單能量成像診斷小腸活動性齣血的價值,以及顯示腸道活動性齣血的最佳單能量值.方法 離體豬小腸和微量註射器連接,分彆設置7種註射流率(分彆為0.500、0.400、0.300、0.200、0.100、0.050、0.025 ml/min)模擬活動性小腸齣血.分彆對上述模型進行普通模式及能譜成像(GSI)模式掃描,每箇流率掃描5次.延遲15、40 s掃描分彆模擬動脈期和門靜脈期.普通模式掃描得到混閤能量圖像,對GSI模式掃描圖像進行重建得到40、50、60、70、80、90和100 keV共7種單能量圖像.觀察不同掃描模式和期相圖像的對比譟聲比(CNR),同時記錄不同掃描模式下對比劑滲齣的檢齣結果.對不同期相和掃描模式圖像的CNR比較採用方差分析,對比劑滲齣檢齣情況的比較採用x2檢驗.結果 動脈期,普通模式和GSI模式對比劑滲齣的檢齣情況(分彆為23/35和31/35)差異有統計學意義(x2=5.185,P=0.023);門靜脈期,2種模式的檢齣情況(分彆為32/35和35/35)差異無統計學意義(x2=1.393,P=0.238).普通模式下,動脈期和門靜脈期的檢齣情況差異有統計學意義(x2=6.873,P=0.009); GSI模式下,動脈期和門靜脈期檢齣情況差異無統計學意義(x2=2.386,P=0.122).動脈期和門靜脈期,8組能量圖像CNR差異均有統計學意義(P均＜0.05),GSI模式50和60 keV單能量圖像對比劑滲齣區的CNR值高于混閤能量圖像,差異有統計學意義(P均＜0.05),各能量組門靜脈期圖像CNR均高于動脈期像,差異均有統計學意義(t值為-3.996～-2.380,P均＜0.05).結論 能譜CT單能量成像診斷小腸活動性齣血的價值優于普通CT,最佳單能量值為50、60 keV,且門靜脈期優于動脈期.
목적 탐토능보CT단능량성상진단소장활동성출혈적개치,이급현시장도활동성출혈적최가단능량치.방법 리체저소장화미량주사기련접,분별설치7충주사류솔(분별위0.500、0.400、0.300、0.200、0.100、0.050、0.025 ml/min)모의활동성소장출혈.분별대상술모형진행보통모식급능보성상(GSI)모식소묘,매개류솔소묘5차.연지15、40 s소묘분별모의동맥기화문정맥기.보통모식소묘득도혼합능량도상,대GSI모식소묘도상진행중건득도40、50、60、70、80、90화100 keV공7충단능량도상.관찰불동소묘모식화기상도상적대비조성비(CNR),동시기록불동소묘모식하대비제삼출적검출결과.대불동기상화소묘모식도상적CNR비교채용방차분석,대비제삼출검출정황적비교채용x2검험.결과 동맥기,보통모식화GSI모식대비제삼출적검출정황(분별위23/35화31/35)차이유통계학의의(x2=5.185,P=0.023);문정맥기,2충모식적검출정황(분별위32/35화35/35)차이무통계학의의(x2=1.393,P=0.238).보통모식하,동맥기화문정맥기적검출정황차이유통계학의의(x2=6.873,P=0.009); GSI모식하,동맥기화문정맥기검출정황차이무통계학의의(x2=2.386,P=0.122).동맥기화문정맥기,8조능량도상CNR차이균유통계학의의(P균＜0.05),GSI모식50화60 keV단능량도상대비제삼출구적CNR치고우혼합능량도상,차이유통계학의의(P균＜0.05),각능량조문정맥기도상CNR균고우동맥기상,차이균유통계학의의(t치위-3.996～-2.380,P균＜0.05).결론 능보CT단능량성상진단소장활동성출혈적개치우우보통CT,최가단능량치위50、60 keV,차문정맥기우우동맥기.
Objective To discuss the diagnostic value of monochromatic energy image spectral CT in active small bowel bleeding and to screen the optimal energy level that indicates active bleeding of the gastrointestinal tract.Methods The bleeding model was established using the small intestines of pigs in vitro.Seven blood flow rates were simulated:0.500,0.400,0.300,0.200,0.100,0.050,0.025 ml/min,respectively.For each rate,a GE Discovery HD750 CT scanner was used in GSI scan mode and 64 slice CT was performed,with a delay of 15 s and 40 s simulated the arterial phase and portal venous phase,respectively.Each out of the blood flow rate in the 2 modes was respectively scanned 5 times.The GSI reconstruction platform was employed to obtain 7 monochromatic energy images(40,50,60,70,80,90,100 keV).A set of polychromatic energy images was obtained from an ordinary scan.The detection rates of the contrast agent exudation regions using the two scanning methods were compared.The contrast to noise ratios(CNR) for the contrast agent exudation regions were measured.Randomized block analysis of Variance was performed to compare the differences in CNR between energy levels.The x2 test was used to compare the detection rates obtained from the 2 scanning methods.Results The detection rates for energy spectral CT and 64 slice CT in the arterial phase were 31/35 and 23/35,respectively; there was significant difference(x2=5.185,P=0.023).The total detection rates of portal venous phase were 35/35 and 32/35,respectively,there was no significant difference(x2=l.393,P=0.238).On the ordinary scan mode,the detection rates of arterial and portal venous phase difference was statistically significant(x2 =6.873,P =0.009);but on the GSI scan mode,there was no significant difference(x2=2.386,P=0.122). The CNR values at 8 group energy levels for arterial phase and portal venous phase were statistically different(respectively P＜ 0.05),the CNR value of the contrast agent exudation regions at 50 keV and 60 keV monochromatic energy images on the GSI scan mode higher than that of polychromatic energy images,the difference was statistically significant(respectively P＜0.05),the CNR in portal venous phase images were higher than that of arterial at all energy groups,differences were statistically significant(t=-3.996 to-2.380,respectively P＜ 0.05).Conclusions Monochromatic energy image spectral CT demonstrates superiority over polychromatic energy images in detecting active bleeding of the gastrointestinal tract.The optimal monochromatic energy value for detection was between 50 keV and 60 keV,and the detection was easier in the portal venous phase than in the arterial phase.
