双能量减影自动去骨技术在双源CT颈动脉成像中的临床应用

The Clinical Applications of Dual Energy Subtract Angiography with Automatic Bone Removal Technique on Dual Source Carotid artery CT angiography

目的探讨双源CT双能量减影中自动去骨技术在颈动脉成像中的临床应用价值。方法对65例临床拟诊颈动脉狭窄的患者,行双源CT颈部血管成像,分析双能量减影自动去骨技术对颈动脉病变的显示,并评价图像质量。结果 65例中3例血管正常变异,33例未见明显病变,血管主干及其分支显示清楚。32例颈动脉粥样硬化,其中4例支架植入术后。双能量CTA对颈根段、颅外段及颅底段血管的满意显示率分别为67.2%、96.2%及66.2%;3个部位血管原始评分比较差异有统计学意义(P=0.000);进一步两两比较,颈根段和颅底段血管的评分差异无统计学意义(P=0.181)。结论双源CT双能量减影成像是一种快速、简便、无创性检查方法,其整体去骨效果较好,血管显示效果最好者是颈动脉颅外段(颈总动脉和颈内动脉颅外段)。

Objective To investigate the clinical applications of dual energy subtract angiography with automatic bone-removal technique on carotid artery using dual source CT.Methods 65 patients with suspected carotid stenoses received carotid artery CT angiography with dual source CT and analyzed lesions of carotid artery.The image quality was evaluated.Results Of 65 cases,3 cases were normal variation;33 cases had no obvious pathological changes;32 cases had atherosclerotic carotid artery,of which 4 were carotid stent implantation.The Ratio of diagnostically satisfied carotid arteries on DECT angiography for collar section,extracranial section,basalis section were 67.2%、96.2%、66.2%,respectively.Statistically significant difference（P=0.000） existed among three sections in Chi-square test,and there was no significant difference between collar section and basalis section of carotid（P=0.181）.Conclusion Dual energy CTA with bone removal was a rapid,convenient and non invasive method.The overall bone subtraction effect was good.The carotid artery were best displayed in the extracranial section（CCA and the extracranial section of ICA）.