双源CT在小肠疾病中的临床诊断价值

The Clinical Diagnosis Value of Dual-source CT in Small Intestinal Diseases

目的:探讨双源CT虚拟平扫在小肠疾病中的临床诊断价值。方法:选取40例进行双源CT的患者,行小肠造影检查,共分常规平扫、动脉期及静脉期对比增强双能量扫描(100kV/140kV),利用后处理工作站软件中的LiverVNC选项卡,获得动脉期虚拟平扫图像、静脉期虚拟平扫图像,并与真实平扫图像进行对比。对获得的图像质量进行主观评分、客观评分,主观评分由2名医生完成,客观评分则在图像上确定感兴趣区,记录下真实平扫、动脉期虚拟平扫、静脉期虚拟平扫的脂肪、肌肉、肝脏及病灶的CT值,机器噪声、病灶的信噪比(SNR)、对比信噪比(CNR)。同时分析三期扫描的总辐射剂量。结果:40例小肠CT造影的患者没有明显异常的有15例,其余4例粘连性肠梗阻,4例慢性结肠炎,3例肠息肉,2例乙状结肠癌,4例肠系膜纤维瘤,5例脂肪瘤,3例回盲部肿物。病灶、脂肪、肌肉虚拟平扫的CT值小于真实平扫,而肝脏虚拟平扫的CT值大于真实平扫,差异无统计学意义(均P>0.05);双能两期扫描辐射剂量低于常规三期扫描的30.8%;3种图像主观评分均≥3分,能满足诊断要求,客观评分发现真实平扫的噪声高于动、静脉期虚拟平扫,信噪比、对比噪声比低于动、静脉期虚拟平扫,差异有统计学意义(均P<0.05)。结论:在患者小肠造影检查中应用双源CT技术,患者接受辐射剂量低,CT图像质量好,临床应用价值较高。

Objective: To explore the clinical value of dual source CT virtual plain scan in small bowel disease. Methods: Forty patients with dual-source CT were enrolled in the study. The patients were treated with routine biopsy, intra-arterial phase and venous phase contrast enhanced dual energy scanning(100 kV/140 kV). Liver VNC was used in post-processing workstation software Tab, to obtain the virtual virtual image of the arterial phase, and to compare the virtual image with the virtual plain image. The subjective score of the obtained image quality, subjective score, subjective score completed by two doctors, the objective score is determined in the image of the region of interest, record the real plain, the virtual phase of the virtual surgery, intravenous virtual plain fat CT, mechanical noise, signal-to-noise ratio(SNR), and signal-to-noise ratio(CNR) of muscle, liver and lesion. At the same time, the total radiation dose of the three phases was analyzed. Results: 40 cases of patients with small intestine CT angiography were not significantly abnormal in 15 patients, the remaining 4 cases of adhesive intestinal obstruction, 4 cases of chronic colitis, 3 cases of intestinal polyps, 2 cases of sigmoid colon cancer, 4 cases of mesenteric fibroma, 5 cases of fat Tumor, 3 cases of ileocecal mass. The CT value of the lesion, fat and muscle virtual plain scan was smaller than that of the true plain scan, while the CT value of the virtual virtual plain of the liver was greater than that of the real scan, the difference was not statistically significant(all P>0.05) And 30.8% of the three kinds of images. The subjective scores of the three kinds of images were equal to or higher than 3 minutes to meet the diagnostic requirements. The objective scale found that the noise of the real plain was higher than that of the VNC, the signal-to-noise ratio, Venous VNC, the difference was statistically significant(all P<0.05). Conclusion: In patients with small bowel angiography using dual-source CT technique, patients receiving low radiation dose, CT image quality is good, the clinical application value is higher.