第3代双源CT虚拟平扫替代常规平扫评估腮腺病变的可行性OA
Feasibility study of using third-generation dual source dual-energy CT virtual non-contrast images instead of true non-contrast images to evaluate parotid gland lesions
目的:探讨第3代双源双能CT虚拟平扫(VNC)图像代替常规真实平扫(TNC)图像评估腮腺病变的可行性.方法:前瞻性纳入术前行腮腺双能增强CT检查、术后经病理证实为腮腺肿物的患者46例(54个病灶).重建动、静脉期VNC图像(VNCa、VNCv).分析腮腺病灶、正常腮腺组织、颌下腺、胸锁乳突肌、皮下脂肪、颈内静脉CT值在两组VNC图像和TNC图像间的一致性,以TNC图像为参照,分别计算VNCa、VNCv与TNC图像中同一组织CT值测量的绝对衰减误差,依次记为VNCaerror、VNCverror.比较TNC、VNCa、VNCv 3组图像的噪声、病变信噪比(SNR)、对比噪声比(CNR)、主观图像质量评分及病变检出率.结果:除胸锁乳突肌外,其他组织CT值在VNCa(或VNCv)和TNC图像上的差异均有统计学意义(P<0.05),但差值均值不超过5 HU.所有测量中VNCaerror<15 HU所占的百分比为94％,VNCverror<15 HU所占的百分比为87％.Bland-Altman分析结果显示VNC图像与TNC图像上各组织CT值一致性较高.两组VNC图像的病变CNR低于TNC图像(P<0.05),VNCa与TNC图像的图像噪声及病变SNR间无统计学差异.3组图像的整体主观图像质量评分间无统计学差异,TNC图像的病变边界和显著性评分高于两组VNC图像(P<0.05).3组图像的腮腺病变检出率相同.腮腺双能量动、静脉期扫描较常规三期扫描辐射剂量降低约33.50％.结论:在腮腺病变的评估中,由第3代双源双能CT获得的VNC图像能够在满足影像诊断需求的前提下降低辐射剂量.且VNCa同VNCv图像相比,可以提供各组织更可靠的CT值及更高的图像质量.
Objective:To evaluate the feasibility of virtual non-contrast(VNC)images using dual source dual-energy CT instead of true non-contrast(TNC)images in patients with parotid gland lesions.Methods:Forty-six patients(with 54 parotid lesions)who underwent preoperative dual-energy enhanced CT examination of the parotid gland and pathologically confirmed parotid masses were prospectively included.VNC images in the arterial and venous phases(VNCa,VNCv)were reconstructed,and the consistency of CT values of parotid gland lesion,normal parotid tissue,submandibular gland,sternocleidomastoid muscle,subcutaneous fat,and internal jugular vein between the two groups of VNC images and TNC images was analyzed.The absolute attenuation error of CT value measurement results between the two groups of VNC images and TNC images(VNCaerror,VNCverror)was calculated.The image noise,lesion signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),subjec-tive image quality scores,and lesion detection rates were compared among the TNC,VNCa,and VNCv images.Results:Except for the sternocleidomastoid muscle,there were statistically significant differences in CT values of other tissues on VNCa(or VNCv)and TNC images(P<0.05),but the mean difference did not exceed 5 HU.The percentage of VNCaerror<15 HU in all measurements was 94％,and the percentage of VNCverror<15 HU was 87％.The Bland-Altman analysis showed a high consistency between the CT values on VNC images and TNC images.The lesion CNR of the two VNC images was lower than that of the TNC images(P<0.05),and there was no statistically significant difference in the noise and lesion SNR between the VNCa images and the TNC images.The overall subjective image quality scores of the three groups of images showed no statistically significant difference,while the lesion boundary and significance scores of the TNC images were higher than those of the two VNC images(P<0.05).The detection rate of parotid gland lesions in the three groups of images was the same.The radiation dose of parotid gland dual energy arterial and venous phase scanning was reduced by about 33.50％compared to conventional three-stage scanning.Conclusion:In the evaluation of parotid gland lesions,VNC images obtained from third-generation dual-source dual energy CT can reduce radiation dose while meeting imaging diagnostic requirements.Compared with VNCv images,VNCa can provide more reliable baseline CT values and higher image quality.
张璐瑶;郭方凯;李宜泽;黄晓颖;陈英敏
河北省人民医院医学影像科,河北 石家庄 050051河北省人民医院医学影像科,河北 石家庄 050051河北省人民医院医学影像科,河北 石家庄 050051河北省人民医院医学影像科,河北 石家庄 050051河北省人民医院医学影像科,河北 石家庄 050051
医药卫生
腮腺肿瘤体层摄影术,X线计算机
Parotid NeoplasmsTomography,X-Ray Computed
《中国临床医学影像杂志》 2026 (9)
624-628,639,6
2024年度河北省政府资助临床医学优秀人才培养项目(编号:2023.10-2026.9).
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