IQon双层探测器光谱CT虚拟45 keV单能量增强图像在肝细胞癌中的应用价值

The Application value of IQon dual-detector spectral CT virtual 45 keV single energy enhanced image in hepatocellular carcinoma

目的:探讨飞利浦IQon双层探测器光谱CT虚拟45 keV单能量增强图像在肝细胞癌中的应用价值。方法:回顾性分析2021年1月-2021年5月在中山大学附属第三医院行飞利浦IQon双层探测器光谱CT增强检查的肝细胞癌患者50例的影像资料。对IQon双层探测器光谱CT虚拟45 keV增强图像与常规120 kVp增强图像进行客观评价、主观一致性评价。比较虚拟45keV增强图像与常规120 kVp增强图像的CT值、SD值和信噪比(SNR)。两名影像诊断医生分别独立采用3分法评价两组图像质量。采用配对样本t检验对客观指标进行比较,两位影像诊断医生主观评分一致性采用Kappa检验。结果:虚拟45 keV增强图像动脉期和门静脉期的CT值、SNR均高于常规120 kVp增强图像,差异具有统计学意义(P<0.05),而两者SD值差异无统计学意义(P>0.05),两名影像诊断医生主观评分具有中高度一致性,虚拟45 keV增强图像与常规120 kVp增强图像Kappa值分别为0.60和0.48。结论:IQon双层探测器光谱CT虚拟45 keV单能量增强图像与常规120 kVp增强图像相比,在虚拟45 keV单能量增强图像上HCC病灶结构清晰度更高,组织间对比度更好,能更准确显示肿瘤边缘和浸润程度,在一定程度上优化了图像质量,有助于临床对HCC的后续治疗。

Objective To explore the application value of Philips IQon dual detector spectral CT virtual 45 keV single energy enhanced image in hepatocellular carcinoma.Methods The imaging data of 50 patients with hepatocellular carcinoma who underwent Philips IQon double-layer detector spectral CT enhanced examination in the Third Affiliated Hospital of Sun Yat-sen University from January 2021 to May 2021 were retrospectively analyzed.The IQon double-layer detector spectral CT virtual 45 keV enhanced image and the conventional 120 kVp enhanced image were evaluated objectively and subjectively.The CT value,SD value and SNR of the virtual 45 keV enhanced image and the conventional 120 kVp enhanced image were compared.The image quality of the two groups was evaluated independently by 3 points method by 2 diagnostic doctors.Paired sample t-test was used to compare the objective indicators,and Kappa test was used to test the consistency of subjective scores between two imaging diagnostic doctors.Results The CT values and SNR of the virtual 45 keV enhanced images were higher than those of the conventional 120 kVp enhanced images in the arterial and portal phase,and the differences were statistically significant(P<0.05),and there was no statistically significant difference between the two SD values(P>0.05).The subjective scores of the two imaging diagnostic doctors were highly consistent.The Kappa values of the virtual 45 keV enhanced images and the conventional 120 kVp enhanced images were 0.60 and 0.48,respectively.Conclusions Compared with the conventional 120 kVp enhanced image,the virtual 45 keV single-energy enhanced image of spectral CT with IQon double-layer detector has higher structural clarity of HCC lesions,better contrast between tissues,and more accurate display of tumor edge and invasion degree,thus optimizing the image quality to a certain extent.It is helpful for the follow-up treatment of HCC.