宝石能谱CT在手足肌腱显示中的初步应用

Preliminary Application of Gemstone Spectral Imaging in Hand and Foot Tendons

目的初步评价宝石能谱CT在手足肌腱显示中的临床应用价值。资料与方法对30例手足疾病的患者行宝石能谱CT和MRI扫描,应用能谱分析软件,寻求肌腱与周围组织具有最佳对比噪声比(contrast-to-noise rati-o,CNR)的最佳单能量(keV)值,并比较宝石能谱CT最佳keV图像与常规混合能量的图像质量。同时,比较宝石能谱CT最佳keV成像与MRI扫描对手足肌腱病变的显示能力。结果手足肌腱成像的最佳keV值为65.09±2.98,宝石能谱CT最佳keV图像质量明显优于混合能量图像(P=0.005<0.05)。宝石能谱CT对于肌腱整体外形、迂曲、粘连、受压及断裂等显示较好,但对于肌腱内部及周围腱鞘、滑膜改变不如MRI敏感。结论宝石能谱CT最佳keV(65 keV)成像能够明显提高手足肌腱扫描的图像质量,并可用于临床诊断。在实际工作中,应根据患者情况合理选择能谱CT扫描和MRI扫描。

Objective To assess the feasibility of Gemstone Spectral Imaging（GSI） in diagnosing hand and foot tendons.Materials and Methods Thirty patients who suffered from hands or feet pain were scanned with GSI CT and MRI.The optimal contrast-to-noise ratio（CNR） for tendons were achieved by spectrum analysis software.The quality of images acquired at the selected optimal monochromatic level and the conventional polychromatic level were compared.Also,the visibility of tendon lesions on GSI and MRI were compared.Results The optimal CNR for hand and foot tendons in monochromatic images was 65.09±2.98 keV.The quality of images acquired at the selected optimal monochromatic level was superior to the conventional polychromatic images（P=0.005〈0.05）.GSI was very useful in displaying the tendon＇s shape,circuity,adherence and rupture.While MRI was more sensitive in displaying inner lesions of tendons,the sheath and synovial membrane than GSI.Conclusion Monochromatic GSI images at 65keV might improve the image quality.GSI and MRI should beselected according to the individual symptom in clinical work.