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1、能谱CT单能量成像在低对比剂腹腔动脉成像中的应用价值任占丽I雷雨欣I,张喜荣IV贾永军I,韩冬I陈晓侠I,于楠12,于勇口，贺太平2*陕西中医药大学附属医院，陕西咸阳，712000陕西中医药大学，陕西咸阳，712000目的：探讨个性化能谱CT单能量成像在腹腔动脉成像中的应用价值。资料与方法：收集腹腔动脉成像患者61例并分为A、B、C三组。A组12OkV管电压,B组和C组采用能谱协议。对比剂用量A组600mgIkg,B组450mgIkg,C组300mgIkgo扫描后B组和C组分别重建65keV和50keV图像。分别测量各腹腔动脉(AA、TCASA、SMA、RA)CT值及SD值，计算SNR值和CN
2、R值。由两名有经验医师采用5分制对图像进行双盲法主观评价。结果：三组有效辐射剂量无显著统计学差异(P0.05),B组、C组对比剂容积较A组显著降低了31%(P0.50)和52%(P0.50)0.75,P0.05)结论：个性化能谱CT单能量成像可以减少腹腔动脉对比剂用量(约31%52%),还可以获得相似或更好图像质量。关键词：能谱CT,单能量成像，对比剂，腹腔动脉Theapp1icationofmonochromaticenergyimagesindua1-energyspectra1CTforimagingce1iacarterywithreducediodine1oadRenZhan1i1,
3、1eiYuxin1,ZhangXirong1,2,JiaYongjun1,HanDong1,ChenXiaoxia1,YuNan1,2,YuYong12,HeTaiping2*1Affi1iatedHospita1ofShaanxiUniversityofChineseMedicine,ShaanxiXianyangJ120002ShaanxiUniversityofChineseMedicine,ShaanxiXianyangJ12000Objective:Toexp1oretheapp1icationofmonochromaticenergyimagesindua1-energyspect
4、ra1CTforimagingce1iacarteries.Method:Sixty-onepatientsforce1iacarteryimagingwereco11ectedandrandom1ydividedintothreegroupswithgroupA,groupBandgroupC(n=20).GroupAusedconventiona1120kVp,whi1egroupBandgroupCuseddua1-energyspectra1contrastdosageswere600mgIkgingroupA,450mgIkgingroupBand300mgIkgingroupC.T
5、he65keVimagesingroupBand50keVimagesingroupCwerereconstructed.TheCTva1ueandSDva1ueofeachce1iacarteriywasmeasuredtoca1cu1atethesigna1tonoiseratio(SNR)andcontrasttonoiseratio(CNR).Thesubjectiveimagescoreswereassessedb1ind1ybytwoexperiencedphysiciansusinga5-pointsystem.Resu1t:Therewerenodifferencesinrad
6、iationdoseofthethreegroups(p0.05)whi1ethecontrastagentvo1umeingroupBandgroupCdecreasedby31%(p0.05)and52%(p0.05)comparedwithgroupACTva1uesofthe50keVimagesingroupCwasthehighest.TheSDva1uesofthe65keVimagesingroupBwastheSNRva1uesofthe65keVimagesingroupBwastheCNRva1uesofthe65keVimagesingroupBwerethehighe
7、standshowedsignificantdifferencesina11ce1iacarteriesbetweengroupBandgroupA(p0.75,P0.05).Conc1usion:Thepersona1izedse1ectionofmonochromaticenergyimageswithdua1-energyspectra1CTcannoton1yreducethecontrastagentvo1ume,buta1soobtainsimi1arorbetterimagequa1ityofce1iacartery.Keywords:spectra1CT,monochromat
8、icenergyimage,contrastagent,ce1iacartery表1三组患者一般资料、辐射剂量及主观评分比较A组(21例)Btf1(20例)C组（20例）统计量P性别（女/男）7/146/146/140.070.965年龄（岁）58.7210.4660.2412.326410.191.238b0.297体重（kg）59.6610.3256.617.6357.3510.990.553b0.578身高（cm）166.756.53166.517.41166.959.920.016b0.984BMI(kgcm2)21.453.7120.573.4420.543.340.464b0.63
9、1注入量（m1）103.0018.5871.3613.8149.899.2270.020b0.000*GSI-CTDI12.774.8413.234.6414.474.810.701b0.500GSI-D1P395.04149.65342.23124.18324.18101.411.732b0.186ED(mSv)5.922.255.141.854.861.521.732b0.186主观评分（分）3.900.6254.330.734.190.6024.709h0.095注：a为2值，b为产值。表2三组患者图像参数比较A组（21例）B组（20例）C组（20例）FPP*P*CT值腹主动脉300.6
10、675.36304.9954.11360.1560.635.390.010.970.01腹腔干298.772.03291.49+55.86339.1849.633.670.030.900.06脾动脉301.3870.8289.5455.65317.6862.021.000.370.780.62肠系膜上动脉296.3372.16291.5954.66347.33+61.524.790.010.960.02肾动脉289.17+74.46286.96+57331.9760.723.100.050.990.07SD值腹主动脉27.112.6617.363.722.96+4.3837.120.000.0
11、00.00腹腔干25.833.7319.86+4.1231.9121.044.670.010.230.21脾动脉21.546.8918.036.8330.84+13.659.470.000.400.01肠系膜上动脉23.63418.067.7326.869.247.480.000.030.27肾动脉21.274.1114.49+5.6526.29+10.6713.090.000.010.06SNR值腹主动脉11.072.5818.134.1116.485.3216.440.000.000.00腹腔干11.632.5815.073.3912.554.165.500.010.000.60脾动脉15
12、.085.5118.89+10.4613.6310.61.780.180.310.83肠系膜上动脉13.154.9419.089.514.76+6.933.560.030.020.71肾动脉13.83.5321.627.3215.067.468.910.000.000.75CNR值腹主动脉21.055.8628.7310.4821.776.455.920.000.010.94腹腔干20.955.7827.7310.2420.786.295.390.010.011.00脾动脉21.176.0827.59.819.916.285.820.000.020.82肠系膜上动脉20.835.7527.77
13、10.4121.156.455.110.010.010.99肾动脉20.415.7327.361020.586.515.480.010.011.00注：0为方差分析显著性，/为AB两组比较，0梆为AC两组比较。F=70,02,p0.0001p0.05F=4.79,p0.05F=3.67,p0.05F=5.39,p0.0560O腹腔干图1三组图像CT值、SD值、SNR.CNR比较的统计图图2A图2B图2C图2D图2E图2F图2A和图2B,A组常规12OkVP和600mgIkg扫描VR和MIP图像，图像主观评分均为4分：图2C和图2D,B组450mgIkg联合能谱最佳单能量(65keV)VR和M1P图像，图像主观评分均为5分；图2E和2F,C组300mgIkg联合能谱最佳单能量(5()keV)V
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