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中华脑科疾病与康复杂志(电子版)

中华脑科疾病与康复杂志(电子版) ›› 2022, Vol. 12 ›› Issue (02) : 110 -114. doi: 10.3877/cma.j.issn.2095-123X.2022.02.009

临床研究

双层探测器光谱CT在颅内血管成像中的应用研究
张勇1, 张妍1, 丁金立1,†(), 张磊1, 马国峰1, 郑凤莲1, 王海阔1, 王志平1, 顾卫彬1   
  1. 1. 100070　北京，首都医科大学附属北京天坛医院放射科
  • 收稿日期:2022-03-12 出版日期:2022-04-15
  • 通信作者: 丁金立

Application study of dual-layer spectral detector CT in intracranial angiography

Yong Zhang1, Yan Zhang1, Jinli Ding1,†(), Lei Zhang1, Guofeng Ma1, Fenglian Zheng1, Haikuo Wang1, Zhiping Wang1, Weibin Gu1   

  1. 1. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
  • Received:2022-03-12 Published:2022-04-15
  • Corresponding author: Jinli Ding
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引用本文：

张勇, 张妍, 丁金立, 张磊, 马国峰, 郑凤莲, 王海阔, 王志平, 顾卫彬. 双层探测器光谱CT在颅内血管成像中的应用研究[J]. 中华脑科疾病与康复杂志(电子版), 2022, 12(02): 110-114.

Yong Zhang, Yan Zhang, Jinli Ding, Lei Zhang, Guofeng Ma, Fenglian Zheng, Haikuo Wang, Zhiping Wang, Weibin Gu. Application study of dual-layer spectral detector CT in intracranial angiography[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(02): 110-114.

目的

对比双层探测器光谱CT（SDCT)不同keV单能级与常规颅内血管CTA的图像质量。

方法

回顾性分析于首都医科大学附属北京天坛医院放射科自2020年4月至2021年3月行颅内血管光谱CT成像的80例患者的临床和影像资料。比较40~90 keV（间隔10 keV）能级图像和常规图像上血管的CT值及相对于胼胝体的对比噪声比（CNR）、图像质量、血管容积重建（VR）难易程度。

结果

能级降低（90 keV降至40 keV），血管CT值显著升高（颈内动脉C7段：242.16~1090.28 HU；基底动脉：217.17~1021.79 HU），而胼胝体压部CT值无明显变化（29.30~37.76 HU）。低能级（40~60 keV）图像上血管的CNR、图像质量评分显著高于常规图像，且比常规图像易于VR，差异均有统计学意义（P<0.05）。

结论

双层SDCT的低能级（40~60 keV）图像比常规图像更利于血管的显示，亦易于进行VR。

关键词: 计算机断层成像, 光谱CT, 颅内血管成像, 双层探测器, 单能级图像
Objective

To compare the image quality between virtual mono-energetic images (VMIs) with different keV and conventional images in intracranial CT angiography (CTA) using dual-layer spectral detector CT (SDCT).

Methods

The clinical and imaging data of 80 patients who underwent intracranial CTA utilizing the SDCT in Radiology Department of Beijing Tiantan Hospital, Capital Medical University from April 2020 to March 2021 were retrospectively analyzed. CT values of the intracranial arteries, their contrast to noise ratio (CNR) compared to the corpus callosum, overall image quality, and difficulty degree of volume rendering (VR) for the intracranial artery were compared between the VMIs (40-90 keV, interval of 10 keV) and the conventional images. Friedman test was used for the statistical analysis.

Results

With the decrease of the energy level (from 90 keV to 40 keV), CT values of the arteries increased significantly (C7 segment of the internal carotid artery: 242.16-1090.28 HU; the basilar artery: 217.17-1021.79 HU), while CT value of the corpus callosum increased slightly (29.30-37.76 HU). Performance of the CNR and the overall image quality on the lower-energy (40-60 keV) images were significantly better than those on the conventional images (P<0.05), meanwhile, VR of the arteries on the lower-energy (40-60 keV) images was easier than that on the conventional images (P<0.05).

Conclusion

Visualization of the intracranial arteries on the lower-energy (40-60 keV) images was better than that on the conventional images, and VR of the intracranial arteries on the lower-energy (40-60 keV) images was easier than that on the conventional images when utilizing the dual-layer SDCT.

Key words: Computed tomography, Spectral CT, Intracranial angiography, Dual-layer detector, Virtual mono-energetic images
表1 常规图像与不同能级图像上所测得的血管和胼胝体压部的CT值以及CNR的比较（Mean±SD）
位置   CON 40 keV 50 keV 60 keV 70 keV 80 keV 90 keV
颈内动脉C7段 CT值 358.08±72.80 1090.28±227.77 726.65±141.08 515.55±108.10 384.11±74.66 298.35±54.23 242.16±43.56
Z值   -3.955 -2.955 -1.955 -0.881 1.030 2.030
P值   <0.001 <0.001 <0.001 0.384 0.122 <0.001
CNR 56.24±9.90 97.95±13.86 84.70±13.18 73.71±14.15 58.17±10.71 43.83±9.66 35.95±8.63
Z值   -3.773 -2.773 -1.773 -0.545 1.227 2.227
P值   <0.001 <0.001 <0.001 >0.999 0.023 <0.001
大脑中动脉M1段 CT值 329.12±63.18 985.43±209.72 657.36±132.62 453.00±89.63 392.40±418.70 260.81±51.12 207.45±37.83
Z值   -3.750 -2.750 -1.720 -0.606 1.235 2.235
P值   <0.001 <0.001 <0.001 >0.999 0.022 <0.001
CNR 53.27±10.80 92.85±15.04 80.61±13.63 67.72±13.05 56.11±10.79 42.83±9.96 34.95±9.23
Z值   -3.718 -2.718 -1.722 -0.521 1.233 2.233
P值   <0.001 <0.001 <0.001 >0.999 0.012 <0.001
大脑前动脉A1段 CT值 291.18±60.79 844.34±190.05 575.60±130.46 400.42±90.60 302.27±64.88 231.42±50.53 187.90±39.09
Z值   -3.712 -2.712 -1.682 -0.439 1.273 2.288
P值   <0.001 <0.001 <0.001 >0.999 0.015 <0.001
CNR 49.94±9.56 87.89±13.45 72.47±12.65 61.76±14.63 51.76±10.66 40.97±9.07 32.95±8.68
Z值   -3.702 -2.702 -1.702 -0.506 1.248 2.261
P值   <0.001 <0.001 <0.001 >0.999 0.011 <0.001
基底动脉 CT值 329.79±67.10 1021.79±248.51 670.05±162.20 466.28±105.14 343.62±70.15 267.38±55.53 217.17±43.42
Z值   -3.881 -2.881 -1.866 -0.776 1.134 2.104
P值   <0.001 <0.001 <0.001 0.079 0.049 <0.001
CNR 60.64±11.92 105.35±15.83 90.69±13.88 79.45±14.76 62.17±12.61 49.89±12.76 38.75±10.68
Z值   -3.782 -2.782 -1.783 -0.454 1.211 2.213
P值   <0.001 <0.001 <0.001 >0.999 0.007 <0.001
大脑后动脉P1段 CT值 276.71±54.42 831.60±186.92 550.07±112.97 379.63±80.88 276.10±65.77 214.93±43.46 171.89±35.53
Z值   -3.561 -2.591 -1.576 -0.121 1.409 2.409
P值   <0.001 <0.001 0.001 >0.999 0.004 <0.001
CNR 45.87±9.81 89.65±12.01 74.13±11.78 60.92±10.80 46.16±9.79 35.86±9.81 24.71±8.70
Z值   -3.671 -2.671 -1.647 -0.596 1.261 2.283
P值   <0.001 <0.001 <0.001 >0.999 <0.001 <0.001
胼胝体压部 CT值 30.44±2.06 37.76±6.86 33.27±5.23 31.04±3.75 30.27±2.15 29.65±1.79 29.30±1.26
Z值   -3.384 -2.233 -0.919 -0.047 0.872 1.070
P值   <0.001 <0.001 >0.999 >0.999 >0.999 0.455
图1 图像整体质量评分和VR难易程度评分的分布图 A：图像整体质量评分；B：VR；与CON比较，aP<0.05；CON：常规图像；VR：血管体绘制
图2 颅内血管自动重建所得的血管体绘制图像的正视图 A：常规图像；B：40 keV；C：50 keV；D：60 keV；E：70 keV；F：80 keV；G：90 keV
[1]
谭新许,庄伟雄,龙小武,等.能谱头颅CTA在脑动脉瘤诊断中的应用价值[J].现代医用影像学, 2020, 29(8): 1447-1448.
[2]
Turan N, Heider RA, Roy AK, et al. Current perspectives in imaging modalities for the assessment of unruptured intracranial aneurysms: a comparative analysis and review[J]. World Neurosurg, 2018, 113: 280-292.
[3]
马得壮.对比3D-CTA、DSA对颅内动脉瘤诊疗价值[J].现代医用影像学, 2017, 26(5): 1373-1374, 1377.
[4]
李玮,刘建新,王霄英,等.低电压、低对比剂剂量头颈CTA的可行性研究[J].放射学实践, 2013, 28(5): 482-485.
[5]
Neuhaus V, Große Hokamp N, Abdullayev N, et al. Comparison of virtual monoenergetic and polyenergetic images reconstructed from dual-layer detector CT angiography of the head and neck[J]. Eur Radiol, 2018, 28(3): 1102-1110.
[6]
任海燕,甄艳华,郑加贺.双层光谱探测器CT临床应用与研究进展[J].中国医学影像技术, 2020, 36(10): 1555-1558.
[7]
向春林,骆磊,胡珊,等.第三代双源CT冠状动脉、头颈动脉一站式CT血管成像:低剂量技术的应用价值[J].放射学实践, 2020, 35(12): 1610-1617.
[8]
中华放射学杂志双层探测器光谱CT临床应用协作组.双层探测器光谱CT临床应用中国专家共识(第一版)[J].中华放射学杂志, 2020, 54(7): 635-643.
[9]
Altahawi FF, Blount KJ, Morley NP, et al. Comparing an accelerated 3D fast spin-echo sequence (CS-SPACE) for knee 3-T magnetic resonance imaging with traditional 3D fast spin-echo (SPACE) and routine 2D sequences[J]. Skeletal Radiol, 2017, 46(1): 7-15.
[10]
Ellis JA, Nossek E, Kronenburg A, et al. Intracranial aneurysm: diagnostic monitoring, current interventional practices, and advances[J]. Curr Treat Options Cardiovasc Med, 2018, 20(12): 94.
[11]
Rajiah P, Abbara S, Halliburton SS. Spectral detector CT for cardiovascular applications[J]. Diagn Interv Radiol, 2017, 23(3): 187-193.
[12]
Lam S, Gupta R, Levental M, et al. Optimal virtual monochromatic images for evaluation of normal tissues and head and neck cancer using dual-energy CT[J]. AJNR Am J Neuroradiol, 2015, 36(8): 1518-1524.
[13]
Forghani R. An update on advanced dual-energy CT for head and neck cancer imaging[J]. Expert Rev Anticancer Ther, 2019, 19(7): 633-644.
[14]
邹志敏,林浩,蔡军,等.脑血管CTA检查中VR和厚层MIP成像技术的临床应用体会[J].医疗装备, 2015, 28(6): 56-57.
[15]
戴贵东,肖正远,兰永树,等.扫描方式对64层螺旋CT头颅CTA图像质量和辐射剂量影响的研究[J].放射学实践, 2012, 27(11): 1271-1273.
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