Non-enhanced Low-tube-voltage High-pitch Dual-source Computed Tomography with Sinogram Affirmed Iterative Reconstruction Algorithm of the Abdomen and Pelvis

Objective To investigate the image quality, radiation dose and diagnostic value of the low-tube-voltage high-pitch dual-source computed tomography(DSCT) with sinogram affirmed iterative reconstruction(SAFIRE) for non-enhanced abdominal and pelvic scans. Methods This institutional review board-approved prospective study included 64 patients who gave written informed consent for additional abdominal and pelvic scan with DSCT in the period from November to December 2012. The patients underwent standard non-enhanced CT scans(protocol 1) [tube voltage of 120 k Vp/pitch of 0.9/filtered back-projection(FBP) reconstruction] followed by high-pitch non-enhanced CT scans(protocol 2)(100 k Vp/3.0/SAFIRE). The total scan time, mean CT number, signal-to-noise ratio(SNR), image quality, lesion detectability and radiation dose were compared between the two protocols. Results The total scan time of protocol 2 was significantly shorter than that of protocol 1(1.4±0.1 seconds vs. 7.6±0.6 seconds, P<0.001). There was no significant difference between protocol 1 and protocol 2 in mean CT number of all organs(liver, 55.4±6.3 HU vs. 56.1±6.8 HU, P=0.214; pancreas, 43.6±5.9 HU vs. 43.7±5.8 HU, P=0.785; spleen, 47.9±3.9 HU vs. 49.4±4.3 HU, P=0.128; kidney, 32.2±2.3 HU vs. 33.1±2.3 HU, P=0.367; abdominal aorta, 44.8±5.6 HU vs. 45.0±5.5 HU, P=0.499; psoas muscle, 50.7±4.1 HU vs. 50.3±4.5 HU, P=0.279). SNR on images of protocol 2 was higher than that of protocol 1(liver, 5.0±1.2 vs. 4.5±1.1, P<0.001; pancreas, 4.0±1.0 vs. 3.6±0.8, P<0.001; spleen, 4.7±1.0 vs. 4.1±0.9, P<0.001; kidney, 3.1±0.6 vs. 2.8±0.6, P<0.001; abdominal aorta, 4.1±1.0 vs. 3.8±1.0, P<0.001; psoas muscle, 4.5±1.1 vs. 4.3±1.2, P=0.012). The overall image noise of protocol 2 was lower than that of protocol1(9.8±3.1 HU vs. 11.1±3.0 HU, P<0.001). Image quality of protocol 2 was good but lower than that of protocol 1(4.1±0.7 vs. 4.6±0.5, P<0.001). Protocol 2 perceived 229 of 234 lesions(97.9%) that were detected in protocol 1 in the abdomen and pelvis. Radiation dose of protocol 2 was lower than that of protocol 1(4.4±0.4 m Sv vs. 7.3±2.4 m Sv, P<0.001) and the mean dose reduction was 41.4%. Conclusion The high-pitch DSCT with SAFIRE can shorten scan time and reduce radiation dose while preserving image quality in non-enhanced abdominal and pelvic scans.

Truncus arteriosus:Diagnosis with dual-source computed tomography angiography and low radiation dose

Truncus arteriosus is an uncommon congenital cardiac abnormality which is characterized by a single arterial trunk origin from the heart that supplies both the systemic,pulmonary and coronary circulation.We present a preterm newborn female patient with type 2 truncusarteriosus,left superior vena cava and aberrant subclavian artery diagnosed with low dose dual-source cardiac computed tomography(CT).We discuss that low dose dual-source cardiac CT has more advantages than other imaging methods and it is an important modality for assessment of patients with conotruncal anomalies such as truncusarteriosus.

Dose Efficiency in Dual Source High-Pitch Computed Tomography of the Chest

Objectives: Evaluation of radiation efficiency of dual source high-pitch (DSHP) chest CT in comparison to single source technique with special regards to individual patient anatomy. Methods: 150 consecutive patients who underwent chest CT with automated tube current modulation were evaluated retrospectively and divided into three study groups, each with an equal quantity of 50 patients (DSHP vs. single source 128 slices vs. single source 16 slices). By using a dedicated workstation, volumetric analyses of each of the scanned anatomic area were performed and correlated to the individual dose length product (DLP). The calculated result was defined as dose efficiency. Results: DLP was 203 mGycm (DSHP), vs. 269 mGycm (single source) vs. 273 mGycm (16 slice CT). The total patient volume was lowest in the dual source group with 18956.3 cm3 (vs. 22481.2 cm3 vs. 22133.8 cm3). With regards to the DLP, the calculated dose efficiency of dual source CT was better than the 128 slice CT (p = 0.045) and the 16 slice CT (p < 0.01). Conclusions: DSHP CT has considerably better dose efficiency compared to 16 slice CT. Compared to 128 slice single source technique, the high-pitch mode does not cause any dose penalty when performing chest CT.

Radiation dose analysis of computed tomography coronary angiography in Children with Kawasaki disease

BACKGROUND There is evolving role of computed tomography coronary angiography(CTCA)in non-invasive evaluation of coronary artery abnormalities in children with Kawasaki disease(KD).Despite this,there is lack of data on radiation dose in this group of children undergoing CTCA.AIM To audit the radiation dose of CTCA in children with KD.METHODS Study(December 2013-February 2018)was performed on dual source CT scanner using adaptive prospective electrocardiography-triggering.The dose length product(DLP in milligray-centimeters-mGy.cm)was recorded.Effective radiation dose(millisieverts-mSv)was calculated by applying appropriate age adjusted conversion factors as per recommendations of International Commission on Radiological Protection.Radiation dose was compared across the groups(0-1,1-5,5-10,and>10 years).RESULTS Eighty-five children(71 boys,14 girls)with KD underwent CTCA.The median age was 5 years(range,2 mo-11 years).Median DLP and effective dose was 21 mGy.cm,interquartile ranges(IQR)=15(13,28)and 0.83 mSv,IQR=0.33(0.68,1.01)respectively.Mean DLP increased significantly across the age groups.Mean effective dose in infants(0.63 mSv)was significantly lower than the other age groups(1-5 years 0.85 mSv,5-10 years 1.04 mSv,and>10 years 1.38 mSv)(P<0.05).There was no significant difference in the effective dose between the other groups of children.All the CTCA studies were of diagnostic quality.No child required a repeat examination.CONCLUSION CTCA is feasible with submillisievert radiation dose in most children with KD.Thus,CTCA has the potential to be an important adjunctive imaging modality in children with KD.

Head dual energy-computed tomography angiography versus neuro-digital subtraction angiography

Dual-energy X-ray absorptiometry provides two modes of head computed tomography （CT） angiography scanning： neuro-digital subtraction angiography and dual-energy CT angiography （DE-CTA）. Previous studies have compared image quality, radiation exposure, and bone removal between neuro-digital subtraction angiography and DE-CTA. However, the number of cases was relatively small. The present study examined 300 suspected cases of cerebrovascular disease and observed the methods and duration of post-processing, examination time, and data volume. Results demonstrated similar image quality between the two methods, but lower radiation doses and shorter examination time in DE-CTA. DE-CTA allowed for faster and more stable scanning performance and post-processing methods, facilitating accurate and direct diagnosis of cerebrovascular disease.

完全型肺静脉异位引流的DSCT诊断价值及研究进展

完全型肺静脉异位引流(TAPVC)指全部肺静脉未正常回流至左心房的一类左向右分流型先天性心脏病,约占新生儿先心病发病率的1%-3%,其多变的解剖类型及肺静脉狭窄程度直接影响病人的临床症状、外科修复方式及预后。双源CT(DSCT)因时间及空间分辨率高、明显减低的辐射剂量及强大的后处理功能,能对TAPVC患者异位肺静脉起源、走行路径、连接位置、血管床状态、其他伴发畸形及心腔大小进行详细评估,成为TAPVC术前、术后随访必要的无创性检查。本文现就TAPVC的发生发展、病理生理学改变及在DSCT检查中的影像特征、价值及研究进展做一简要综述。

Feasibility and Diagnostic Accuracy for Assessment of Coronary Artery Stenosis of Prospectively Electrocardiogram-gated High-pitch Spiral Acquisition Mode Dual-source CT Coronary Angiography in Patients with Relatively Higher Heart Rates: in Comparison wit

Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography coronary angiography (CTCA) in patients with relatively higher heart rates (HR) compared with catheter coronary angiography (CCA). Methods Forty-seven consecutive patients with relatively higher HR (>65 and <100 bpm) (20 male, 27 female; age 55±10 years) who both underwent dual-source CTCA and CCA were prospectively included in this study. All patients were performed CTCA using high pitch mode setting at 20%-30% of the R-R interval for the image acquisition. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a three-point scale (1: excellent to 3: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). Considered CCA as the standard of reference, the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Radiation dose values were calculated using the dose-length product. Results Image quality was rated as being score 1 in 92.4% of segments, score 2 in 6.1% of segmentsand score 3 in 1.5% of segments. The average image quality score per segment was 1.064±0.306. The HR variability of patients with image score 1, 2 and 3 were 2.29±1.06 bpm, 5.17±1.37 bpm, 8.88±1.53 bpm, respectively. The average HR variability of patients with different image scores were significantly different (F=170.402, P=0.001). The sensitivity, specificity, positive and negative predictive values were 92.6%, 97.0%, 87.6%, 98.3%, respectively, per segment and 90.0%, 95.2%, 85.3%, 96.9%, respectively, per vessel and 100%, 63.6%, 90.0%, 100%, respectively, per patient. The effective radiation dose was on average 0.86±0.16 mSv. Conclusion In patients with HR more than 65 bpm and below 100 bpm without cardiac arrhythmia, the prospectively electrocardiogram-gated high-pitch spiral acquisition mode with image acquired timing set at 20%-30% of the R-R interval provides a high diagnostic accuracy for the assessment of coronary stenoses combined with a 1.5% of non-diagnostic coronary segments and a radiation dose below 1 mSv.

Intravenous Contrast Material Administration at High-pitch Dual-source CT Coronary Angiography: Bolus-tracking Technique with Shortened Time of Respiratory Instruction Versus Test Bolus Technique

Objective To investigate the feasibility of acquiring the similar homogeneous enhancement using bolus-tracking techniques with shortened respiratory time in prospectively electrocardiogram-gated high-pitch spiral acquisition mode (Flash mode) coronary computed tomography angiography (CCTA) compared with test bolus technique. Methods One hundred and eighty-four consecutive patients with mean heart rate ≤65 beats per minute undergoing CCTA were prospectively included in this study. The patients were randomly divided into two groups. Patients in the group A (n=92) instructed to shorten respiratory time received CCTA using bolus-tracking technique with high-pitch spiral acquisition mode (Flash mode), while those in the group B (n=92) underwent CCTA with test bolus technique. The attenuation in the ascending aorta, image noise, contrast-to-noise ratio and radiation doses of the two groups were assessed. Results There were no significant differences in the mean attenuation values in the ascending aorta (483.18±59.07 HU vs. 498.7±83.51 HU, P=0.183), image noise (21.4±4.5 HU vs. 20.9±4.3 HU, P=0.414), contrast-to-noise ratio (12.1±4.2 vs. 13.8±5.1, P=0.31) between the groups A and B. There were no significant differences in the radiation dose of dynamic monitoring scans (0.056±0.026 mSv vs. 0.062±0.018 mSv, P=0.068) and radiation dose of angiography (0.94±0.07 mSv vs. 0.96±0.15 mSv,P=0.926) between the two groups, while 15 mL less contrast material volume was administered in the group A than the group B. Conclusion Bolus-tracking technique with shortened time of respiratory in Flash mode of dual-source CT yields the similar homogeneous enhancement with less contrast material in comparison to the test bolus technique.

Application of an Advanced Image-Based Virtual Monoenergetic Reconstruction of Dual Source Dual-Energy CT Data at Low keV Increases Image Quality for Esophageal Cancer Patients Imaging

Purpose: To explore the significance of dual-source computed tomography (DECT) virtual monoenergetic reconstructions technology in improving the imaging quality of esophageal cancer patients. Materials and methods: 68 patients with clinically suspected esophageal cancer (all confirmed by pathology) were collected. Routine plain scan was performed with SIEMENS Force dual-energy CT and then dual-phase scans were performed. The venous phase images were respectively subjected to traditional virtual monoenergetic reconstructions (Mono_E) and new generation virtual monoenergetic reconstructions (Mono+). Mono_E 55 keV and Mono+ 55 keV virtual single-energy images were obtained respectively. The signal-to-noise ratio (SNR) of normal esophageal tissue and esophageal cancer lesions, noise and contrast noise ratio (CNR tumor) of normal esophageal tissue and esophageal cancer lesions were compared among 100 kV images, Mono_E images and Mono+ images. At the same time, two imaging physicians read the films and scored the images of each group by using a 5-point scoring method. Results: Mono+ 55 keV images, SNR, SNRtumor, noise and CNRtumor were statistically different from those of 100 kV images and Mono_E images (P < 0.05). And Mono+ 55 keV images also had the highest subjective score, with statistical significance (P 55 keV images had the best quality. Conclusion: The new generation of virtual monoenergetic reconstructions post-processing (Mono+) could reduce image noise and improve the contrast between esophageal cancer lesions and normal esophageal tissues, which was of great significance to improve the imaging quality of esophageal cancer patients and improve the early detection rate of esophageal cancer.

Significance of an Advanced Image-Based Virtual Monoenergetic Reconstruction of Dual Source Dual-Energy CT Data at Low keV Increases Image Quality for Portal Vein System of Pancreatic Cancer Patients

Purpose: To explore the significance of dual-source computed tomography (DECT) virtual monoenergetic reconstructions technology in improving image quality for portal vein system of pancreatic cancer patients. Materials and methods: 47 patients with clinically suspected pancreatic cancer (all confirmed by pathology) were collected. Routine plain scan was performed with Siemens Force dual-source dual-energy CT followed by 3 scans respectively carried out in arterial phase, portal phase and delayed phase. Traditional virtual monoenergetic reconstructions (Mono_E) and new generation of virtual monoenergetic reconstructions (Mono+) were respectively performed on portal vein images to obtain virtual single energy images including Mono_ E70 keV, Mono_E 55 keV and Mono+ 70 keV and Mono+ 55 keV. The signal-to-noise ratio (SNR) and noise of portal vein, normal pancreatic tissues and pancreatic lesions of 100 kV, Mono_E and Mono+ images were compared. In addition, the contrast noise ratio of portal vein and lesions as well as pancreatic tissues and lesions (CNR PV, CNRtumor) were also compared. At the same time, two imaging physicians with rich clinical experiences read the films and scored the images of each group by using the 5-point scoring method. Results: Mono+ 55 keV images including SNRpv, SNRpanc, SNRtumor, Noise, CNRpv, CNRtumor were statistically different from 100 KV images and Mono_E images (P < 0.05). As for the subjective score, Mono+ 55 keV image score also had the highest score, which had statistical significance (P < 0.05). The results showed that Mono+ 55 keV images had the best quality. Conclusion: The new generation of virtual Mono+ post-treatment can reduce image noise. Low energy Mono+ images can improve the contrast between pancreatic cancer lesions and portal of pancreatic cancer patients.

国人内听道DSCT的解剖研究

目的应用双源CT(dual source computed tomography,DSCT)观察国人内听道的形态,并测量内听道各径线数值,探讨其临床应用价值。方法对正常志愿者402例804耳行颞骨薄层扫描,多平面重建,观察内听道的形态,并对各相关径线进行测量。结果内听道形态为平行管状699耳,喇叭口状53耳,壶腹状50耳,不规则型2耳。内听道长度为(9.810±1.830)mm,内听道底管径为(5.084±0.739)mm×(3.246±0.613)mm,中段管径为(5.044±0.956)mm×(4.228±0.791)mm,内耳门区前后径为(5.049±1.05)mm,内耳门区上下径为(5.657±1.196)mm。两侧内听道各测量数值统计学上无显著差异;男女之间有统计学差异,这与文献报道不同;部分年龄组之间也有统计学差异。结论DSCT薄层扫描后多平面重建可清楚显示内听道的形态,并能精确测量内听道的管径及长度,对活体解剖测量具有指导意义,为临床和影像检查提供诊断依据。

DSCT前门控技术在小儿肺动脉发育异常中的应用

目的:探讨双源CT(DSCT)前瞻性心电门控技术在小儿肺动脉发育异常中的临床应用价值。方法:对经胸壁超声心动图(TTE)检查拟诊为先天性心脏病合并肺动脉畸形的43例患儿,采用DSCT前门控扫描,根据患儿体重调节管电压和管电流。记录患儿受检的辐射剂量。以手术和(或)X线心血管造影(CAG)结果作为标准,计算DSCT前门控和TTE对肺动脉发育畸形的诊断准确率,利用X^2检验比较两者差异是否具有统计学意义。结果:DSCT前门控对肺动脉发育异常的诊断准确率为97.96%(48/49),TTE的准确率为73.47%(36/49),差异具有统计学意义(X^2=31.24,P<0.05)。DSCT前门控主观图像质量评分为4.20±0.80,平均有效辐射剂量为(0.38±0.08)mSv。结论:DSCT前门控可有效减低辐射剂量,是诊断小儿肺动脉发育异常合理有效的检查方法之一。

西门子Force双源CT在冠脉CTA成像中的影响因素及解决方案

目的 探讨西门子Force双源CT在冠脉成像中的影响因素和解决方案。方法分析2 021年6月至2022年6月的冠脉CT影像学数据,随机抽取50位在西门子Force双源CT行冠脉CTA的患者作为对照组,观察组则由另50位改进扫描方案后进行检查的患者组成,对两组患者的冠脉成像合格率和图像质量进行比较,以及评估冠脉主要分支的信噪比,对比噪声比。结果 冠脉成像观察组的合格率98.7%大于对照组9 7.5%,观察组冠脉主要分支的信噪比均高于对照组,差异具有统计学意义(t=3.472,4.127,5.135, 2.205,4.546,3.722,2.544,2.771,P均<0.05)观察组冠脉主要分支的对比噪声比均高于对照组,差异具有统计学意义(t=2.164,2.986,6.341,3.085,3.272,2.713,3.520,2.835,P均<0.05)。结论 通过分析西门子Force双源CT冠脉成像的不利影响因素并改进扫描方案,可以有效提高冠脉CTA的图像质量,为临床提供了更可靠的依据。

Diagnostic Value of Prospective Electrocardiogram-triggered Dual-source Computed Tomography Angiography for Infants and Children with Interrupted Aortic Arch

Background：Accurate assessment of intra-as well as extra-cardiac malformations and radiation dosage concerns are especially crucial to infants and children with interrupted aortic arch （IAA）.The purpose of this study is to investigate the value of prospective electrocardiogram （ECG）-triggered dual-source computed tomography （DSCT） angiography with low-dosage techniques in the diagnosis of IAA.Methods：Thirteen patients with suspected IAA underwent prospective ECG-triggered DSCT scan and transthoracic echocardiography （TTE）.Surgery was performed on all the patients.A five-point scale was used to assess image quality.The diagnostic accuracy ofDSCT angiography and TTE was compared with the surgical findings as the reference standard.A nonparametric Chi-square test was used for comparative analysis.P＜0.05 was considered as a significant difference.The mean effective radiation dose （ED） was calculated.Results：Diagnostic DSCT images were obtained for all the patients.Thirteen IAA cases with 60 separate cardiovascular anomalies were confirmed by surgical findings.The diagnostic accuracy of TTE and DSCT for total cardiovascular malformations was 93.7％ and 97.9％ （P＞0.05）,and that for extra-cardiac vascular malformations was 92.3％ and 99.0％ （P ＜ 0.05）,respectively.The mean score of image quality was 3.77 ± 0.83.The mean ED was 0.30 ± 0.04 mSv （range from 0.23 mSv to 0.39 mSv）.Conclusions：In infants and children with IAA,prospective ECG-triggered DSCT with low radiation exposure and high diagnostic efficiency has higher accuracy compared to TTE in detection of extra-cardiac vascular anomalies.

双源CT评估胃癌肿瘤血管生成及其与膜联蛋白A和血清组织多肽特异性抗原的关系研究

目的:探讨分析双源CT(DSCT)评估胃癌肿瘤血管生成及其与膜联蛋白A(AnnexinA)和血清组织多肽特异性抗原(TPS)的关系。方法:选取医院收治的380例胃癌患者,根据微血管密度中位数35个/视野为界定标准,将其中206例微血管密度中位数>35个/视野的患者纳入高密度组,将174例微血管密度中位数<35个/视野的患者纳入低密度组,比较两组DSCT成像参数,Annexin A和TPS水平;采用Peason相关性分析法评估DSCT各项成像参数与Annexin A和TPS的相关性。结果:高密度组患者血容量(BV)、血流量(BF)及表面通透性(PS)水平及达峰时间(TTP)高于低密度组,差异有统计学意义(t=5.942,t=8.901,t=14.945,t=12.513;P<0.05),但平均通过时间(MTT)水平高于低密度组,差异无统计学意义;高密度组血清AnnexinA和TPS水平均显著高于低密度组患者,差异有统计学意义(t=5.371,t=5.223;P<0.05);DSCT中BV、BF及PS与Annexin A和TPS呈正相关(rAnnexin A=0.621,r=0.652,r=0.492;rTPS=0.716,r=0.823,r=0.512;P<0.05);DSCT中TTP与Annexin A和TPS呈负相关(r=-0.572,r=-0.548;P<0.05)。结论:DSCT可准确、有效地评估肿瘤血管生成,且其参数与Annexin A和TPS具有较好相关性,对于肿瘤活性评估具有较好参考价值,可作为胃癌早期诊断的重要指导依据。

双源CT造影对冠心病诊断及经皮冠状动脉介入治疗支架内再狭窄评估的价值分析

目的:探究双源CT造影(DSCTA)在冠心病诊断及经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的预测评估价值。方法:选取在医院欲行PCI术治疗的88例冠心病患者,所有患者术前及PCI术后6个月均采用DSCTA及冠状动脉造影(CAG)检查,以CAG检查结果为“金标准”,对患者左冠状动脉主干、左前降支、左回旋支、右冠状动脉等298段冠状动脉血管的狭窄情况进行评估,并对比DSCTA检查对冠心病诊断及PCI支架内再狭窄预测的灵敏度、特异度、阳性预测值、阴性预测值及准确率。结果:在88例患者中的298段冠状动脉血管中,CAG诊断评估血管狭窄程度中无明显狭窄、中度狭窄和重度狭窄分别为234段、47段和17段,DSCTA诊断分别为231段、46段和21段,两种诊断方法的血管狭窄评估比较差异无统计学意义(χ^(2)=0.088,χ^(2)=0.013,χ^(2)=0.450;P>0.05)。在88例患者植入的134枚支架中,DSCTA诊断与CAG诊断评价结果比较,差异无统计学意义(χ^(2)=0.579,P>0.05)。DSCTA检查诊断冠状动脉狭窄的诊断准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为94.97%、90.63%、96.15%、86.57%和97.40%;诊断PCI支架内再狭窄的诊断准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为92.54%、95.65%、90.91%、84.62%和97.56%。结论:DSCTA在冠心病诊断与PCI中支架再狭窄评价具有良好的一致性,且安全、价格低廉,并可为临床诊断提供更全面的冠状动脉诊断信息。

双源CT胆囊三角区结构探查在胆囊结石合并胆囊炎术前评估中的效能分析

目的:探讨双源CT(DSCT)胆囊三角区结构探查在胆囊结石合并胆囊炎术前评估中的价值。方法:选取医院收治的109例胆囊结石合并胆囊炎患者(胆固醇型41例,混合型29例,胆色素型39例)纳入观察组;同时选取经DSCT诊断为非胆囊疾病的80例患者纳入对照组,比较两组患者的胆囊动脉、胆囊管走行情况,分析观察组不同结石成分CT值差异及对结石成分的预测。结果:观察组胆囊动脉、胆囊管不同评分(0分、1分、2分)优于对照组,差异有统计学意义(Z=-2.173,Z=-4.433;P<0.05)。观察组和对照组胆囊动脉正常走行比例分别为93.58%(102/109)和100.00%(80/80),胆囊管正常走行比例分别为94.50%(103/109)和100.00%(80/80),差异均无统计学意义。观察组胆囊动脉异型走行中Ⅰb型3例(占2.75%),Ⅱa型2例(占1.83%),Ⅱb型2例(占1.83%)。观察组中胆固醇型、混合型和胆色素型患者的性别、高血压及糖尿病患者占比,差异均无统计学意义;胆固醇型结石CT值为(60.20±11.28)HU,明显低于混合型和胆色素型结石,差异有统计学意义(F=12.201,P<0.05)。CT值预测胆固醇型结石的受试者工作特征(ROC)曲线下面积为0.915,95%CI为0.858~0.971,截断值为71.84 HU,灵敏度和特异度分别为88.20%和87.80%。结论:在胆囊结石合并胆囊炎中,DSCT胆囊三角区结构探查能够清晰显示胆囊动脉及胆囊管情况,可为术前评估提供可靠依据,对结石成分有一定预测价值。

外泌体miRNA-3651水平联合双源CT对非小细胞肺癌的诊断价值及与预后的相关性研究

目的探究外泌体微小RNA(miR)-3651水平联合双源计算机断层扫描(CT)对非小细胞肺癌(NSCLC)的诊断价值,并分析其与患者预后的相关性。方法收集2016年2月—2018年2月本院97例确诊的NSCLC患者为研究对象,淋巴结转移(转移组)52例、无淋巴结转移(无转移组)45例;根据随访3年患者生存情况,生存(生存组)36例、死亡(死亡组)61例。实时荧光定量PCR(RT-qPCR)法检测外泌体中miR-3651水平;双源CT扫描方法检测肿瘤转移情况。结果与无转移组相比,转移组外泌体miR-3651水平、双源CT指标碘浓度、NIC、动脉期斜率均升高(P<0.05)。与生存组相比,死亡组外泌体miR-3651水平、双源CT指标碘浓度、NIC、动脉期斜率均升高(P<0.05)。Cox分析显示外泌体miR-3651、双源CT指标NIC、动脉期斜率是NSCLC患者预后死亡的独立危险因素。结论外泌体miR-3651、双源CT指标均对NSCLC患者淋巴结转移具有一定诊断价值,且是预后死亡的独立危险因素,在临床上应该受到重视。

MRI-DWI联合双源CT扫描及血清GP73、AFP-L3检测对小肝癌的诊断价值

目的探讨核磁共振弥散加权成像(MRI-DWI)联合双源X线计算机断层摄影(DSCT)扫描及血清高尔基体蛋白73(GP73)、甲胎蛋白异质体L3(AFP-L3)检测对小肝癌的诊断价值。方法回顾性选取2020年1月至2022年12月长治医学院附属和平医院收治的80例小肝癌患者为观察组,另选同期50名健康体检者为对照组,均进行MRI-DWI与DSCT检查。比较两组DSCT指标[肝组织血流量、平均通过时间(MTT)、肝动脉灌注量(HAP)],MRI-DWI指标[b值分别为50、400、800 s/mm^(2)的表观弥散系数(ADC)值]结果,同时检测其血清GP73、AFP-L3水平,通过受试者工作特征(ROC)分析DSCT、ADC值及GP73、AFP-L3诊断小肝癌的价值,分析MRI-DWI联合DSCT及GP73、AFP-L3诊断小肝癌的价值。结果观察组肝组织血流量、MTT、HAP分别为(201.23±81.65)mL/(min·100 g)、(10.03±3.06)s、(45.81±32.22)%,均显著高于对照组[(154.56±68.32)mL/(min·100 g)、(8.03±2.56)s、(28.95±15.62)%],差异均有统计学意义(P<0.05)。观察组b值为400、800 s/mm^(2)时ADC值分别为(1.45±0.42)、(1.22±0.41)mm^(2)/s,均显著低于对照组[(3.26±0.68)、(2.41±0.59)mm^(2)/s],差异均有统计学意义(P<0.05)。观察组血清GP73、AFP-L3水平分别为[(65.46±15.45)、(65.45±21.32)ng/mL],均显著高于对照组[(32.56±15.89)、(16.29±10.56)ng/mL],差异均有统计学意义(P<0.05)。经ROC分析证实DSCT指标与ADC值及GP73、AFP-L3均能用于小肝癌的诊断中,曲线下面积均大于0.6,诊断价值较好(P<0.05)。经一致性分析证实,MRI-DWI联合DSCT参数及GP73、AFP-L3诊断小肝癌的准确率93.85%、敏感度93.75%、特异度94.00%、阳性预测值96.15%、阴性预测值90.38%、Kappa值=0.871。结论MRI-DWI与DSCT及GP73、AFP-L3均可用于诊断小肝癌,但联合应用敏感度更高,可提高诊断结果的客观性、准确率。

双源CT多部位CTA一站式扫描在心脑血管病诊断中的应用分析

目的分析双源计算机断层扫描(CT)多部位CT血管造影(CTA)一站式扫描在心脑血管病诊断中的应用价值。方法选取本院2020年6月至2021年10月收治的195例疑似心脑血管病患者(其中疑似脑血管病91例、疑似心血管病104例)作为研究对象,所有患者均行双源CT多部位CTA一站式扫描与数字剪影血管造影(DSA)检查,以DSA检查为金标准,分析双源CT多部位CTA一站式扫描在心脑血管病中的诊断价值。结果经DSA检查,最终有89例确诊为脑血管病(脑梗死52例、脑动脉瘤37例),100例确诊为心血管病(急性心肌梗死58例、冠心病心绞痛42例),共发现狭窄血管有大脑前动脉10支,大脑中动脉11支,大脑后动脉9支,颈动脉18支,椎基底动脉12支、左前降支43支,右冠状动脉37支,回旋支33支;共发现42枚动脉瘤,其中大脑前、中、后动脉17枚,颈动脉8枚,椎基底动脉7枚,前、后交通动脉10枚;经双源CT多部位CTA一站式扫描,最终87例确诊为脑血管病(脑梗死50例、脑出血37例),98例确诊为心血管病(急性心肌梗死58例、冠心病心绞痛40例),共发现狭窄血管有大脑前动脉10支,大脑中动脉10支,大脑后动脉9支,颈动脉17支,椎基底动脉12支、左前降支41支,右冠状动脉36支,回旋支33支;共发现40枚动脉瘤,其中大脑前、中、后动脉16枚,颈动脉8枚,椎基底动脉7枚,前、后交通动脉9枚;诊断脑动脉瘤、头颈动脉狭窄、冠状动脉狭窄与DSA的符合率分别为95.24%(40/42)、95.00%(57/60)、97.35%(110/113);诊断脑血管病的灵敏度、特异度、准确度分别为96.63%(86/89)、50.00%(1/2)、95.60%(87/91),诊断心血管病的灵敏度、特异度、准确度分别为97.00%(97/100)、75.00%(3/4)、96.15%(100/104)。结论双源CT多部位CTA一站式扫描在心脑血管病中具有较高的诊断价值,可为临床诊治提供参考依据。