摘要
目的建立128-CT全肝灌注成像的最优化扫描技术方案。方法在90例行全肝CT灌注(CTporfusion,CTP)扫描的患者中,采用双因素方差的方法比较不同管电压(100kVp vs.120kVp)下的图像伪影和组织噪声;采用配对分析的方法比较不同对比剂浓度(300mgI/mL vs.370mgI/mL)下肝动脉、门脉及脾脏的时间密度曲线(time density curve,TDC)达峰高度;采用配对分析的方法比较不同对比剂注射速度(5mL/s vs.8mL/s)下肝动脉、门脉及脾脏的TDC达峰时间。采用配对t检验的方法对90例患者中的50例进行运动校正及滤过技术前后的图像伪影分析,并进行同一观察者采集数据的可重复性检验。结果不同管电压下图像伪影和组织噪声的差异无统计学意义(P>0.05),肝脏不同叶段(左外叶、膈顶与左内叶、右前叶、右后叶、尾叶)伪影和噪声的差异有统计学意义(P<0.001)。对比剂浓度为300mgI/mL和370mgI/mL时,肝动脉达峰高度分别为(391.33±33.57)Hu和(288.67±32.26)Hu,门脉达峰高度分别为(124.13±17.66)Hu和(78.67±21.91)Hu,脾脏达峰高度分别为(111.33±17.16)Hu和(59.2±17.78)Hu,差异均有统计学意义(P<0.000 1)。对比剂注射速度为5mL/s与8mL/时,肝动脉达峰时间分别为(13.33±1.84)s和(9.07±1.16)s,门脉达峰时间分别为(30.95±5.87)s和(19.2±2.46)s,脾脏达峰时间分别为(22.47±4.67)s和(14.87±2.13)s,差异均有统计学意义(P<0.00 1)。运动校正滤过技术前后伪影的差异有统计学意义(P<0.001)。同一观察者前后两次测量的全肝灌注参数中,BF、BV、PVP、HPI及P值的相关性较好,相关系数>0.90,而ALP值的相关性相对较差,相对系数为0.723,差异无统计学意义(P<0.05)。结论 128-CT能够进行全肝灌注成像检查。采用100kVp管电压、8mL/s对比剂注射速率、370mgI/mL对比剂浓度和运动校正及滤过技术是更优化的CT全肝灌注扫描方案。同一观察者之间的可重复性好。
Objective To optimize protocol of whole liver CT perfusion （CTP） with 128-CT. Methods In 90 patients received whole liver CTP, pair analysis was used to compare image quality under different tube electric voltage （100 kVp vs. 120 kVp） ,different contrastation of contrast media （300 mgI/mL vs. 370 mgI/mL） ,different injection rate of contrast media （5 mL/s vs. 8 mL/s） and with or without motion correction and filtration. Liver artifact, tissue noise, time density （TDC） peaktime and peak value of hepatic artery, portal vein and spleen were evaluated. Repeatability test for data collected from the same observer was also done. Results Two-way analysis of variance （ANOVA） indicated artifact and tissue noise had no correlation with different tube electric voltage （P 〉0.05 ）, but showed statistical difference in different lobe （P〈0. 001）. When the concentrations of contrast media were 370 mgI/mL and 300 mgI/mL,peak value were （391.33 ±33.57） Hu and （288.67 ±32.26） Hu for hepatic artery,（124. 13±17. 66） Hu and （78.67±21.91） Hu for portal vein, （111. 33±17. 16） Hu and （59.2±17.78） Hu for spleen, and the differences were statistically significant （P〈0. 001）. When the injection rates of contrast media were 5 mL/s and 8 mL/s,peak time were （13.33±1.84） s and （9.07±1.16）s for hepatic artery, （30.95±5.87） s and （19.2 ±2. 46） s for portal vein, （22. 47±4.67） s and （14.87 ± 2.13） s for spleen, and the differences were statistically significant （P〈0. 0001）. Artifact scores before and after the application of motion correction and filtration were 1.9±0.3 and 0. 6±0. 3, and the difference was statistically significant （P〈0. 001 ）. There was no significant difference in CTP parameter sabtained at different time points by the same observer. Conclusions 128-CT could be used for whole liver CTP. Tube electric voltage of 100 kVp provides good images, when combined with 8 mL/s injection rate, 370 mgI/mL contrast media conce
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2013年第3期323-327,共5页
Fudan University Journal of Medical Sciences
关键词
肝脏
灌注
CT成像
liver
perfusion
CT imaging
