CAJ | 학술논문

目的：探讨和评价采用宝石能谱 CT 单能量成像及自适应统计迭代重建（ASiR）技术门静脉图像的质量，并将其与传统多排螺旋 CT 的门静脉图像进行对比分析。方法：搜集临床有恶性肿瘤病史、治疗后随诊行上腹部增强扫描检查的患者90例，按照数字表法随机分为 A 组（最佳 CNR 单能量组）、B 组（60keV＋40％ASiR 组）及 C 组（常规螺旋 CT组），每组30例。A 组门静脉期采用能谱扫描模式扫描，双电压快速切换；从扫描数据中重组出40～140keV 能量段的101组单能量图像，得出门静脉主干 CNR 随能量变化曲线，进而得出能谱 CT 成像中最佳能量点的单能图像；B 组门静脉期采用能谱扫描模式扫描，双电压快速切换，从扫描数据中重组出60keV 的单能量图像，并加上40％的 ASiR。C 组门静脉期采用常规肝脏增强扫描模式扫描得到门静脉期扫描图像。采用单因素方差分析比较3组图像中门静脉、肝实质的平均CT 值及其差值、图像噪声及 CNR。由2名放射科医师在盲法下对3组图像进行主观图像质量评分。结果：门静脉最佳CNR 单能量水平集中在55．87keV 左右。在 A、B、C 组图像的 CNR 分别为6．81±1．87、8．09±2．29、3．30±1．08，图像质量评分分别为4．28±0．58分、4．35±0．56分和3．58±0．46分。A、B 组的 CNR 和图像质量评分均显著高于 C 组（P ＜0．001）。结论：MSCT 门静脉成像中最佳 CNR 单能量与60keV＋40％ASiR 图像较常规螺旋 CT 图像成像质量大大提高，均可在临床血管成像方面广泛推广。
목적：탐토화평개채용보석능보 CT 단능량성상급자괄응통계질대중건（ASiR）기술문정맥도상적질량，병장기여전통다배라선 CT 적문정맥도상진행대비분석。방법：수집림상유악성종류병사、치료후수진행상복부증강소묘검사적환자90례，안조수자표법수궤분위 A 조（최가 CNR 단능량조）、B 조（60keV＋40％ASiR 조）급 C 조（상규라선 CT조），매조30례。A 조문정맥기채용능보소묘모식소묘，쌍전압쾌속절환；종소묘수거중중조출40～140keV 능량단적101조단능량도상，득출문정맥주간 CNR 수능량변화곡선，진이득출능보 CT 성상중최가능량점적단능도상；B 조문정맥기채용능보소묘모식소묘，쌍전압쾌속절환，종소묘수거중중조출60keV 적단능량도상，병가상40％적 ASiR。C 조문정맥기채용상규간장증강소묘모식소묘득도문정맥기소묘도상。채용단인소방차분석비교3조도상중문정맥、간실질적평균CT 치급기차치、도상조성급 CNR。유2명방사과의사재맹법하대3조도상진행주관도상질량평분。결과：문정맥최가CNR 단능량수평집중재55．87keV 좌우。재 A、B、C 조도상적 CNR 분별위6．81±1．87、8．09±2．29、3．30±1．08，도상질량평분분별위4．28±0．58분、4．35±0．56분화3．58±0．46분。A、B 조적 CNR 화도상질량평분균현저고우 C 조（P ＜0．001）。결론：MSCT 문정맥성상중최가 CNR 단능량여60keV＋40％ASiR 도상교상규라선 CT 도상성상질량대대제고，균가재림상혈관성상방면엄범추엄。
Objective:To investigate and evaluate the quantitative and subjective quality of the portal vein images u-sing spectral CT monochromatic imaging and adaptive statistical iterative reconstruction (ASiR),and to compare three ima-ges with the images obtained from conventional CT.Methods:90 tumor patients who had received routine abdomen CT scans were randomly divided into three groups.Group A (optimal monochromatic group)included 30 patients who underwent fast kVp-switching dual-energy abdominal enhanced CT,from which 101 sets of portal venous phase recombinant monochromat-ic (40~140keV)images were generated,and the optimal monochromatic set with the highest contrast-to-noise ratio (CNR) were obtained.Group B (60keV+40%ASiR group)included 30 patients who underwent fast kVp-switching dual-energy abdominal enhanced CT,and portal venous phase 60keV recombinant monochromatic images were obtained and reconstruc-ted with 40% ASiR.Group C (conventional multi-detector CT group)included 30 patients who underwent traditional ab-dominal enhanced multi-detector CT,and portal venous phase images were obtained.The average CT values of the portal vein and the hepatic parenchyma,the portal-hepatic HU difference,the image noise and the CNR were obtained and com-pared among the three groups using the single factor analysis of variance.Two board-certified radiologists interpreted the selected image sets independently for image quality scores.Results:The monochromatic images were found to yield the opti-mal CNR for portal vein at 55.87keV.In group A,B and C,the CNR were 6.81 ±1.87,8.09 ±2.29 and 3.30 ±1.08,and the image quality scores were 4.28±0.58,4.35±0.56 and 3.58±0.46,respectively.The CNR and image quality scores of group A and B were significantly higher than that of group C (all P <0.001).Conclusion Compared to conventional CT ima-ging,both the 60keV spectral CT monochromatic imaging with 40%ASiR and the optimal monochromatic CT imaging can significantly improve the image quality of portal vein.