64排螺旋CT和宝石能谱CT在肝硬化门静脉高压侧支循环中的应用研究

The application of 64 slice spiral CT and gemstone spectral CT in diagnosis of collateral circulation of portal hypertension due to liver cirrhosis

目的探讨64排螺旋CT和宝石能谱CT在肝硬化门静脉高压侧支循环中的应用况。方法选取2017年1～3月医院行宝石能谱CT门静脉成像的患者40例作为能谱CT组,同期行64排螺旋CT门静脉成像的患者40例作为多层螺旋CT组(MSCT组),比较2组图像噪声、门静脉影像的对比度噪声比(CNR)、门静脉主干CT值、肝实质CT值、门静脉-肝实质CT差值及有效辐射剂量(ED),统计两名影像科医师对CT图像质量主观评分情况。结果能谱CT组图像噪声值低于MSCT组,CNR高于MSCT组,差异均有统计学意义(P<0.05);能谱CT组门静脉主干CT值、肝实质CT值及门静脉-肝实质CT差值均明显高于MSCT组,ED低于能谱MSCT组,差异有统计学意义(P<0.05);能谱CT组两位影像学医师的图像质量主观评分均高于MSCT组,差异有统计学意义(P<0.05)。结论与MSCT相比,宝石能谱CT门静脉成像不仅可减少图像噪声,提高门静脉-肝实质对比剂及图像质量,还可减少辐射剂量。

Objective To investigate and compare the application of 64 slice spiral CT and gemstone spectral CT in diagnosis of collateral circulation of portal hypertension due to liver cirrhosis. Methods A total of 40 patients who underwent gemstone spectral CT portal venography in our hospital from January 2017 to March 2017 were enrolled as spectral CT group,and the other 40 patients who underwent 64 slice spiral CT portal venography were enrolled as multi-slice spiral CT (MSCT) group.The image noise,contrast to noise ratio (CNR) of portal images,CT value of the main portal vein,CT value of liver parenchyma,the difference of portal vein-liver parenchyma CT value and effective radiation dose (ED) were observed and compared between the two groups.Moreover the subjective scores of the quality of CT images made by two radiologists were statistically analyzed. Results The image noise value in spectral CT group was significantly lower than that in MSCT group,however, the CNR was significantly higher than that in MSCT group ( P <0.05).The CT value of main portal vein,CT value of liver parenchyma and difference of portal vein-liver parenchyma CT value in spectral CT group were significantly higher than those in MSCT group,while ED was significantly lower than that in MSCT group ( P <0.05).In addition the subjective scores of the quality of CT images made by two radiologists in spectral CT group were significantly higher than those in MSCT group ( P < 0.05). Conclusion As compared with MSCT,the gemstone spectral CT portal venography can not only reduce the image noise and improve the portal vein-liver parenchyma contrast and the image quality, but also can reduce the radiation dose.