Phase behavior of gas condensate in porous media using real-time computed tomography scanning

The phase behavior of gas condensate in reservoir formations differs from that in pressure-volume-temperature(PVT)cells because it is influenced by porous media in the reservoir formations.Sandstone was used as a sample to investigate the influence of porous media on the phase behavior of the gas condensate.The pore structure was first analyzed using computed tomography(CT)scanning,digital core technology,and a pore network model.The sandstone core sample was then saturated with gas condensate for the pressure depletion experiment.After each pressure-depletion state was stable,realtime CT scanning was performed on the sample.The scanning results of the sample were reconstructed into three-dimensional grayscale images,and the gas condensate and condensate liquid were segmented based on gray value discrepancy to dynamically characterize the phase behavior of the gas condensate in porous media.Pore network models of the condensate liquid ganglia under different pressures were built to calculate the characteristic parameters,including the average radius,coordination number,and tortuosity,and to analyze the changing mechanism caused by the phase behavior change of the gas condensate.Four types of condensate liquid(clustered,branched,membranous,and droplet ganglia)were then classified by shape factor and Euler number to investigate their morphological changes dynamically and elaborately.The results show that the dew point pressure of the gas condensate in porous media is 12.7 MPa,which is 0.7 MPa higher than 12.0 MPa in PVT cells.The average radius,volume,and coordination number of the condensate liquid ganglia increased when the system pressure was between the dew point pressure(12.7 MPa)and the pressure for the maximum liquid dropout,Pmax(10.0 MPa),and decreased when it was below Pmax.The volume proportion of clustered ganglia was the highest,followed by branched,membranous,and droplet ganglia.This study provides crucial experimental evidence for the phase behavior changing process of gas condensate in porous media during the depletion production of gas condensate reservoirs.

Heterogeneity induced strain localization in block-in-matrix-soils subjected to uniaxial loading using real-time CT scanning

Block-in-matrix-soils(bimsoils)are geological mixtures that have distinct structures consisting of relatively strong rock blocks and weak matrix soils.It is still a challenge to evaluate the mechanical behaviors of bimsoils because of the heterogeneity,chaotic structure,and lithological variability.As a result,only very limited laboratory studies have been reported on the evolution of their internal deformation.In this study,the deformation evolution of bimsoils under uniaxial loading is investigated using real-time X-ray computed tomography(CT)and image correlation algorithm(with a rock block percentage(RBP)of 40%).Three parameters,i.e.heterogeneity coefficient(K),correlation coefficient(CC),and standard deviation(STD)of displacement fields,are proposed to quantify the heterogeneity of the motion of the rock blocks and the progressive deformation of the bimsoils.Experimental results show that the rock blocks in bimsoils are prone to forming clusters with increasing loading,and the sliding surface goes around only one side of a cluster.Based on the movement of the rock blocks recorded by STD and CC,the progressive deformation of the bimsoils is quantitatively divided into three stages:initialization of the rotation of rock blocks,formation of rock block clusters,and formation of a shear band by rock blocks with significant rotation.Moreover,the experimental results demonstrate that the meso-motion of rock blocks controls the macroscopic mechanical properties of the samples.

Influence of pore structure heterogeneity on channeling channels during hot water flooding in heavy oil reservoir based on CT scanning

Hot water flooding is an effective way to develop heavy oil reservoirs.However,local channeling channels may form,possibly leading to a low thermal utilization efficiency and high water cut in the reservoir.The pore structure heterogeneity is an important factor in forming these channels.This study proposes a method that mixes quartz sand with different particle sizes to prepare weakly heterogeneous and strongly heterogeneous models through which hot water flooding experiments are conducted.During the experiments,computer tomography(CT)scanning identifies the pore structure and micro remaining oil saturation distribution to analyze the influence of the pore structure heterogeneity on the channeling channels.The oil saturation reduction and average pore size are divided into three levels to quantitatively describe the relationship between the channeling channel distribution and pore structure heterogeneity.The zone where oil saturation reduction exceeds 20%is defined as a channeling channel.The scanning area is divided into 180 equally sized zones based on the CT scanning images,and threedimensional(3D)distributions of the channeling channels are developed.Four micro remaining oil distribution patterns are proposed,and the morphology characteristics of micro remaining oil inside and outside the channeling channels are analyzed.The results show that hot water flooding is more balanced in the weakly heterogeneous model,and the oil saturation decreases by more than 20%in most zones without narrow channeling channels forming.In the strongly heterogeneous model,hot water flooding is unbalanced,and three narrow channeling channels of different lengths form.In the weakly heterogeneous model,the oil saturation reduction is greater in zones with larger pores.The distribution range of the average pore size is larger in the strongly heterogeneous model.The network remaining oil inside the channeling channels is less than outside the channeling channels,and the hot water converts the network remaining oil into cluster,film,and droplet remaining oil.

Fatigue properties and damage constitutive model of salt rock based on CT scanning

To investigate the macroscopic fatigue properties and the mesoscopic pore evolution characteristics of salt rock under cyclic loading,fatigue tests under different upper-limit stresses were carried out on salt rock,and the mesoscopic pore structures of salt rock before and after fatigue tests and under different cycle numbers were measured using CT scanning instrument.Based on the test results,the effects of the cycle number and the upper-limit stress on the evolution of cracks,pore morphology,pore number,pore volume,pore size,plane porosity,and volume porosity of salt rock were analyzed.The failure path of salt rock specimens under cyclic loading was analyzed using the distribution law of plane porosity.The damage variable of salt rock under cyclic loading was defined on basis of the variation of volume porosity with cycle number.In order to describe the fatigue deformation behavior of salt rock under cyclic loading,the nonlinear Burgers damage constitutive model was further established.The results show that the model established can better reflect the whole development process of fatigue deformation of salt rock under cyclic loading.

Three-dimensional finite element simulation and reconstruction of jointed rock models using CT scanning and photogrammetry

The geometry of joints has a significant influence on the mechanical properties of rocks.To simplify the curved joint shapes in rocks,the joint shape is usually treated as straight lines or planes in most laboratory experiments and numerical simulations.In this study,the computerized tomography (CT) scanning and photogrammetry were employed to obtain the internal and surface joint structures of a limestone sample,respectively.To describe the joint geometry,the edge detection algorithms and a three-dimensional (3D) matrix mapping method were applied to reconstruct CT-based and photogrammetry-based jointed rock models.For comparison tests,the numerical uniaxial compression tests were conducted on an intact rock sample and a sample with a joint simplified to a plane using the parallel computing method.The results indicate that the mechanical characteristics and failure process of jointed rocks are significantly affected by the geometry of joints.The presence of joints reduces the uniaxial compressive strength (UCS),elastic modulus,and released acoustic emission (AE) energy of rocks by 37%–67%,21%–24%,and 52%–90%,respectively.Compared to the simplified joint sample,the proposed photogrammetry-based numerical model makes the most of the limited geometry information of joints.The UCS,accumulative released AE energy,and elastic modulus of the photogrammetry-based sample were found to be very close to those of the CT-based sample.The UCS value of the simplified joint sample (i.e.38.5 MPa) is much lower than that of the CT-based sample (i.e.72.3 MPa).Additionally,the accumulative released AE energy observed in the simplified joint sample is 3.899 times lower than that observed in the CT-based sample.CT scanning provides a reliable means to visualize the joints in rocks,which can be used to verify the reliability of photogrammetry techniques.The application of the photogrammetry-based sample enables detailed analysis for estimating the mechanical properties of jointed rocks.

Analysis of the microstructure of microbial solidified sand and engineering residue based on CT scanning

A close relationship exists between the pore network structure of microbial solidified soil and its macroscopic mechanical properties.The microbial solidified engineering residue and sand were scanned by computed tomography(CT),and a three-dimensional model of the sample was established by digital image processing.A spatial pore network ball-stick model of the representative elementary volume(REV)was established,and the REV parameters of the sample were calculated.The pore radius,throat radius,pore coordination number,and throat length were normally distributed.The soil particle size was larger after solidification.The calcium carbonate content of the microbial solidified engineering residue’s consolidated layer decreased with the soil depth,the porosity increased,the pore and throat network developed,and the ultimate structure was relatively stable.The calcium carbonate content of the microbial solidified sand’s consolidated layer decreased and increased with the soil depth.The content reached the maximum,the hardness of the consolidated layer was the highest,and the development of the pore and throat network was optimum at a depth of 10–15 mm.

Quantitative investigation of multi-fracture morphology during TPDF through true tri-axial fracturing experiments and CT scanning

Due to the reservoir heterogeneity and the stress shadow effect, multiple hydraulic fractures within one fracturing segment cannot be initiated simultaneously and propagate evenly, which will cause a low effectiveness of reservoir stimulation. Temporary plugging and diverting fracturing(TPDF) is considered to be a potential uniform-stimulation method for creating multiple fractures simultaneously in the oilfield. However, the multi-fracture propagation morphology during TPDF is not clear now. The purpose of this study is to quantitatively investigate the multi-fracture propagation morphology during TPDF through true tri-axial fracturing experiments and CT scanning. Critical parameters such as fracture spacing, number of perforation clusters, the viscosity of fracturing fluid, and the in-situ stress have been investigated. The fracture geometry before and after diversion have been quantitively analyzed based on the two-dimensional CT slices and three-dimensional reconstruction method. The main conclusions are as follows:(1) When injecting the high viscosity fluid or perforating at the location with low in-situ stress, multiple hydraulic fractures would simultaneously propagate. Otherwise, only one hydraulic fracture was created during the initial fracturing stage(IFS) for most tests.(2) The perforation cluster effectiveness(PCE) has increased from 26.62% during the IFS to 88.86% after using diverters.(3) The diverted fracture volume has no apparent correlation with the pressure peak and peak frequency during the diversion fracturing stage(DFS) but is positively correlated with water-work.(4) Four types of plugging behavior in shale could be controlled by adjusting the diverter recipe and diverter injection time, and the plugging behavior includes plugging the natural fracture in the wellbore, plugging the previous hydraulic fractures, plugging the fracture tip and plugging the bedding.

Cryostructures and ground ice content in ice-rich permafrost area of the Qinghai-Tibet Plateau with Computed Tomography Scanning

Permafrost is an important part of the cryosphere,playing an integral role in the hydrologic cycle,ecology,and influencing human activity.Melting of ground ice can drastically change landscapes and associated thaw subsidence may induce instability of infrastructure.The terrain conditions on the Qinghai-Tibet Plateau are complex,and the spatial distribution of ground ice is highly variable,so knowledge of its abundance and variability is required for impact assessments relating to the degradation of permafrost.This study examined 55 permafrost samples from warm,ice-rich permafrost region in Beiluhe Basin,Qinghai-Tibet Plateau.The samples were examined using Computed Tomography scanning,and the ice content and cryostructure were determined.The results indicated that:1)variation in volumetric ice content was considerable(0%-70%),with a mean value of 17%;2)seven cryostructures were identified,including crustal,vein,lenticular,ataxitic,reticulate and layered cryostructure;3)volumetric ice content varied by cryostructure,with the highest associated with layered and ataxitic cryostructures.Volumetric ice contents were lowest for samples with pore and lenticular cryostructures.This work provides detailed ground ice content and will be helpful for assessing thaw subsidence and infrastructure stability on Qinghai-Tibet Plateau.

Hemangioblastoma Incidentally Discovered at CT Scan in Bamako: About a Case

Hemangioblastomas are benign vascular tumors of the brain. These are rare tumors, usually located in the cerebellum and most often affecting young adults. The aim was to study the value of CT in the management of hemangioblastoma through observation. We report the case of a 38-year-old patient referred to the radiology and Medical Imaging Department of the Marie Curie Medical Clinic in Bamako, Mali, for an orbito-cerebral CT scan in a context of bilateral eyelid edema. The examination was performed using multi-slice computed tomography (16 slices) with reconstruction in the 3 planes of space without and with the injection of an iodinated contrast agent. The CT scan was crucial in making the diagnosis of hemangioblastoma incidentally, which allowed for adequate management. The patient was operated on, and the radiological outcome was favorable, without significant cystic formation, after postoperative control and clinical signs were resolved. CT can be an interesting alternative in countries like ours despite MRI being the examination of choice in hemangioblastomas.

Real-time Quantitative RT-PCR for CT9 Level in Human Cancer

CT9 is a recently cloned cancer-testis antigen, which is a member of the bromodomain and extraterminal family. Each member of this protein family contains two N-terminal bromodomain motifs. We investigated the distribution of CT9 in different tissues and the possibility for it to be used as a potential therapeutic target in cancer treament. By using the real-time RT-PCR method and 18SrRNA as an internal standard, we analyzed the CT9 expression in several normal human tissues and in the tissues of patients suffering from cancer. The result of this study shows that the highest level of mRNA is only present in testis tissue because the CT9 expression has not been detected in other normal tissues. In 6 of 10 cases of gastric adenocarcinoma, in 3 of 10 cases of esophageal squamous cell carcinoma, in 2 of 9 cases of endometrial carcinoma and only in 1 of 12 cases of brain cancer, the low level expression of CT9 was detected. In none of the 12 cases of cervical squamous cell carcinoma, the expression of CT9 was detected. Since the high level expression of CT9 is only found in the normal testis tissue, but the low expression in cancer tissues, for example tissues of cervical squamous cell carcinoma, brain cancer, endometfial adenocarcinoma, esophageal squamous cell carcinoma, we conclude that CT9 cannot be used as a cancer therapeutic target molecule for cervical squamous cell carcinoma, brain cancer, endometrial adenocarcinoma, esophageal squamous cell carcinoma.

Study of Scanning Dose Optimization on Chest and Abdomen Enhanced CT Imaging

Objective: To investigate the correlation between radiation dose and radiation risk when patients are scanned by 64-slice spiral CT. Materials and Methods: SPSS 17.0 is used statistically for analyzing the patient’s scanning parameters, radiation dose of monitoring and examining the patients who are scanning of their abdomen, chest and pelvic in our affiliated hospital. Results: SPSS statistical analysis shows that the factor related to radiation dose is scanning layer;the basic characteristics such as height and heart rate don’t affect the patient’s scan dose directly. Conclusion: Increasing the delay time after injection can reduce the scan numbers and monitoring layers of the machine, thus reduce the patient’s radiation dose and tube’s exposure time.

Application of Dual-Source CT TurboFlash Coarse Pitch Scanning in Coronary Artery Imaging

Objective: To compare and analyze the image quality and radiation dose of three scanning modes of dual-source CT coronary artery retrospectively, and to discuss the application value of TurboFlash coarse pitch scanning mode. Methods: The imaging data of 100 patients who underwent CT coronary angiography (CCTA) using Siemens force CT retrospective gated triggering spiral scan (RES-SPIRAL), adaptive prospective gated triggering sequence scan (SEQ) and prospective coarse pitch scan (TurboFlash) retrospectively was collected. The image quality was evaluated by objective and subjective methods. The effective radiation dose of patients was compared and analyzed, and the indications of the three scanning modes were analyzed. The application value of dual-source CT TurboFlash coarse pitch scanning in coronary artery imaging was evaluated. Results: The results showed that the left main coronary artery, the right coronary artery and their tertiary branches could be clearly displayed in the three groups of images: the left anterior descending branch, the left circumflex branch, and their three-level branches. There was no statistical difference in subjective image quality among the three groups of pictures (P > 0.05). There was no statistical difference in objective evaluation indexes, such as CT value, SNR, CNR and Noise among the three groups (P > 0.05). The patient radiation dose results showed that the effective radiation dose ED of RES-SPIRA scan was (9.22 ± 1.33) mSv. The dose of SEQ was (2.88 ± 2.47) mSv, and the dose of TurboFlash was (0.51 ± 0.16) mSv. There was significant difference in comparison of the three groups (P 0.05). RES-spiral scanning had the highest radiation dose and TurboFlash coarse pitch scanning (TurboFlash) had the lowest radiation dose. Conclusion: TurboFlash coarse pitch scanning is low in dosage, fast in speed and wide in adaptability. It is especially suitable for the elderly, children, coma and other patients who cannot cooperate with breath-holding examination, as well as for the screening and examination of coronary artery diseases in asymptomatic population. Undoubtedly, it is a worthy method of heart coronary artery examination.

Correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer

Objective:To study the correlation between CT dynamic enhanced scanning parameters and serum tumor markers before and after radiofrequency ablation in patients with lung cancer.Methods:60 patients with advanced non-small cell lung cancer who were treated in this hospital between January 2015 and January 2017 were divided into control group(n=30)and observation group(n=30)by random number table method.Control group received conventional intravenous chemotherapy,and observation group received intravenous chemotherapy combined with radiofrequency ablation.The differences in CT dynamic enhanced scanning parameter levels and serum tumor marker contents were compared between the two groups of patients before and after treatment.Pearson test was used to evaluate the correlation between CT dynamic enhanced scanning parameters and serum tumor marker contents in patients with advanced non-small cell lung cancer.Results:Before treatment,the differences in CT dynamic enhanced scanning parameter levels,non-organ-specific tumor marker contents and vascular tumor marker contents were not statistically significant between the two groups of patients(P>0.05).After treatment,CT dynamic enhanced scanning parameters PH and perfusion value levels of observation group were lower than those of control group(P<0.05);serum non-organ specific tumor markers CA125,CA153,CEA and CYFRA21-1 contents of observation group were lower than those of control group;serum vascular tumor markers VEGF,Ang-2,HIF-1 and MMP-9 contents were lower than those of control group(P<0.05).Pearson test showed that CT dynamic enhanced scanning parameters PH and perfusion value levels in patients with non-small cell lung cancer were positively correlated with serum non-organ specific tumor marker and vascular tumor marker contents.Conclusion:Adjuvant radiofrequency ablation can significantly reduce the tumor malignancy of patients with advanced non-small cell lung cancer.

基于CT技术的黄原胶加固土干湿循环条件下力学性能和微观结构劣化机制研究

干湿循环对岩土体的工程特性具有重要影响。采用CT扫描技术和力学测试,对加入不同含量黄原胶(0%,0.5%,1.5%)加固的黏土在经历不同次数(0,1,4,8,12次)干湿循环作用下的力学性能和微观结构劣化机制进行了研究,得到结论:(1)黄原胶能够有效提高土体的抗压强度和耐干湿循环效果。随着黄原胶含量的增加,干湿循环作用后的强度损失逐渐减小,当循环次数从0次增加到4次时,对于加入黄原胶含量分别为0%,0.5%,1.5%的试样,抗压强度分别损失了42.75%,17.2%,14.04%。(2)加固土的抗压强度与干湿循环次数之间保持指数下降的关系,当循环次数达到4次后,随着循环次数的进一步增加,抗压强度和弹性模量均在较小的变化范围内波动。(3)随着干湿循环次数的增加,黄原胶加固土的孔隙率表现出先增加后减小的趋势,连通孔隙不断扩展,而孤立孔隙表现出先增加后减小的趋势。(4)随着试样的干燥,黄原胶在土颗粒间形成网状基质,提高土体的强度和耐干湿循环能力。

基于深度学习的煤岩Micro-CT裂隙智能提取与应用

为解决煤岩CT裂隙图像识别中矸石影响以及不同尺度裂隙识别的问题,设计并实现了一种基于深度学习的煤岩裂隙提取网络模型(MCSN),该模型基于U-Net网络,利用其编码器-解码器结构和跳跃连接,可实现从复杂煤岩体中分割出完整的裂隙结构图像。首先,通过煤岩工业CT扫描系统获取煤岩体内部扫描图片后,人工标注出CT图像中的裂隙结构,并利用数据增强扩充标注的原始数据制作出煤岩CT裂隙数据集;然后,将训练好的VGG16模型权重通过迁移学习技术移至U-Net编码器部分,使得整个主干特征提取网络具有更强的裂隙结构特征提取能力;同时采用深度可分离空洞卷积模块(DCAC)和残差模块对U-Net模型中解码器部分进行改进,有效提升了CT图像中裂隙结构的识别能力,展现出了优越的分割精度和鲁棒性。为验证提出的煤岩裂隙提取网络模型的有效性,将MCSN的提取结果与经典的卷积神经网络及阈值分割方法的结果进行了对比,实验对比结果显示,提出的模型在定性分析和定量分析方面优势明显。这种多尺度融合的策略可以有效提取出复杂煤岩体图像中的裂隙,提高了裂隙识别效率和精度。将该模型应用到巷道围岩钻孔裂隙识别中,通过对钻孔成像仪采集到的窥孔视频和平面展开图进行裂隙提取,并结合二者提取结果进行交叉验证,得到了精准的巷道围岩裂隙分布范围,给出了穿层抽采钻孔的注浆封孔范围,提高了煤层瓦斯抽采体积分数。

基于CT断层扫描的木质家具与原木内部缺损三维可视化研究

研究木质家具与原木试件内部缺损三维可视化,有助于木质文物精准干预性保护与木材高效规划利用。凸显三维成像技术可视化优势,对木质文物保护具有重要意义。本文采用philips16排CT——A机型Brilliace16对试件三维断层扫描。通过对CT扫描后原始图像的分割,获取品质较佳的三维数字模型。继而对分割后的图像进行切面与断面两个维度的手工着色,随后通过三维重建可得到开裂、虫洞、朽坏等不同形式缺损的三维形态,并可得到与之对应的精准三维模型。试验证明:通过三维重建,可获取木质试件内部不同类型三维缺损形态的可视化分析,可对缺损形态进行360°观察,并可获取三维缺损形态的表面积、体积等精准物理参数。本技术可为木质文物修复提供三维缺损形态的精准参数及直观可视化三维模型。

CT增强扫描灰度直方图纹理分析技术对肺癌患者术前恶性程度评估及对预后的预测价值

目的探究CT增强扫描灰度直方图纹理分析技术对肺癌患者术前恶性程度评估及对预后的预测价值。方法选择2018年5月至2022年9月在我院就诊的且经术后病理证实的肺癌患者580例作为研究对象。依据术后病理分期,将研究对象分为高分化组(183例)、中分化组(195例)、低分化组(202例)。根据预后情况,将其分为预后良好组(356例)和预后不良组(224例)。由2名医师提取患者CT增强扫描灰度直方图纹理参数。受试者工作特征(receiver operating characteristic,ROC)曲线分析特征参数对肺癌患者术前恶性程度的诊断效能及预后的预测价值。多因素Logistic回归分析预后不良的重要影响因素并构建人工神经网络模型。Pearson分析检验参数间的相关性。结果均值、10%分位、50%分位等参数在高、中、低分化三组中有显著差异。三个参数对评估肺癌患者恶性程度均具有一定的诊断效能,且三者联合诊断效能最佳。均值、10%分位、50%分位是预后不良的保护因素,三者联合预测肺癌患者的曲线AUC值大于各指标单独预测的AUC值。ROC曲线和累积增益图表明该模型预测能力良好。纹理特征参数中,69.44%的参数具有相关性。结论CT增强扫描灰度直方图纹理参数在一定程度上反应肺癌患者术前恶性程度信息,给术前预测以及预后提供了重要方法。

基于CT扫描受压注浆体试块三维孔裂隙结构参数表征

目的为研究注浆体试块单轴压缩过程中孔裂隙结构演化特征,方法以级配砂砾注浆体试块为研究对象,对其单轴压缩过程分阶段进行工业CT扫描,并采用AVIZO对CT切片进行分析,重构孔裂隙结构三维模型,定量表征孔裂隙与孔喉特征参数。结果结果表明:单轴压缩下,试块依次经历孔裂隙萌生、发育、扩展与贯通阶段,孔裂隙演化特征比较明显,萌生阶段孔隙数增幅为14.41%,无明显贯通;发育阶段孔隙数增加326.91%,伴有一定数目孔隙贯通;扩展阶段孔隙数减少了57.79%,孔隙等效直径最大值增幅为223.45%,大部分孔隙贯通为裂隙;贯通阶段孔裂隙数目几乎不变,孔隙等效直径最大值增幅为92.83%,裂隙贯通后形成多个破裂面。峰值后试块出现连通孔隙,该阶段注浆体孔隙与喉道发育完全,试块破坏。结论研究结果可为后续破碎岩石注浆工程实践提供参考。

左心耳CT血管造影双期扫描在房颤患者中诊断左心耳血栓的应用价值

目的:探讨左心耳CT血管造影(CTA)双期扫描在房颤患者中诊断左心耳血栓的应用价值。方法:回顾性收集2020年1月至2022年6月房颤患者36例,所有患者均行左心耳(LAA)CTA双期扫描和经食管超声心动图(TEE)检查。以TEE检查结果为“金标准”,分别计算LAA-CTA第一期和第二期诊断LAA血栓的敏感性、特异性、阳性预测值、阴性预测值及诊断符合率,并采用Kappa检验评价LAA-CTA第一期和第二期诊断结果与TTE诊断结果的一致性。结果:LAA-CTA第一期诊断左心耳血栓患者21例,第二期诊断左心耳血栓患者15例,TTE诊断左心耳血栓患者14例;LAA-CTA第一期诊断LAA血栓的敏感性、特异性、阳性预测值、阴性预测值及诊断符合率分别为64.29%、45.45%、42.86%、66.67%及52.78%;LAA-CTA第二期诊断LAA血栓的敏感性、特异性、阳性预测值、阴性预测值及诊断符合率分别为92.86%、90.91%、86.67%、95.24%、91.67%,差异均有统计学意义(P<0.05)。LAA-CTA第一期诊断左心耳血栓结果与TEE诊断结果一致性一般(Kappa=0.089),而LAA-CTA第二期诊断左心耳血栓结果与TEE诊断结果一致性较好(Kappa=0.827),差异有统计学意义(P<0.05)。结论:左心耳CTA双期扫描均能发现LAA血栓,但第二期扫描诊断血栓的敏感性、特异性及诊断符合率均升高,且第二期诊断血栓结果与TEE一致性较好,因此左心耳CTA双期扫描方法在诊断LAA血栓方面具有较高的临床应用价值。

CT增强检查中碘对比剂外渗病人皮肤损伤风险预测模型的构建

目的:探讨CT增强检查中碘对比剂外渗病人皮肤损伤发生风险的影响因素,构建并验证风险预测模型。方法:采用便利抽样法抽取2023年1月—7月在广西医科大学第一附属医院放射科接受CT增强检查的碘对比剂外渗病人286例作为研究对象,自制CT增强检查碘对比剂外渗病人皮肤损伤风险调查问卷对病人进行调查,采用单因素分析、Logistic回归分析筛选CT增强检查中碘对比剂外渗病人皮肤损伤发生风险的影响因素,构建风险预测模型,绘制列线图,运用受试者工作特征(ROC)曲线、校准曲线评价模型。结果:CT增强检查中碘对比剂外渗病人皮肤损伤发生率为18.5%。Logistic回归分析结果显示,过敏史、碘对比剂黏稠度、碘对比剂注射速度是CT增强检查中碘对比剂外渗病人皮肤损伤的影响因素(P<0.05),基于上述结果构建的预测模型建模组ROC曲线下面积为0.842[95%CI(0.770,0.915)],约登指数为0.667,最优截断值灵敏度为0.893,特异度为0.774;验证组ROC曲线下面积为0.924[95%CI(0.872,0.975)],约登指数为0.793,最优截断值灵敏度为0.891,特异度为0.902。Hosmer-Lemeshow检验结果显示,χ2=9.566,P=0.221 5,校准曲线与参考线相接近。结论:CT增强检查中碘对比剂外渗病人皮肤损伤风险预测模型预测效能良好,可为医务人员制订个性化的预防措施提供参考。