Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193, Japan.
Radiology. 2011 Jul;260(1):139-47. doi: 10.1148/radiol.11101459. Epub 2011 Mar 15.
To prospectively compare 320-detector volumetric and 64-detector helical computed tomographic (CT) images of the pancreas for depiction of anatomic structures, image noise, and radiation exposure.
This study was approved by the institutional review board, and written informed consent was obtained. A total of 154 patients (85 men, 69 women; age range, 26-85 years; mean age, 67 years) who underwent biphasic (arterial and pancreatic phase) contrast material-enhanced CT performed with a 320-detector scanner were randomized into two groups: the 320-detector group and the 64-detector group. Biphasic transaxial multiplanar reformatted images and volume-rendered CT angiograms were obtained. CT numbers in the abdominal aorta, pancreas, and abdominal wall fat tissue; signal-to-noise ratio (SNR); and dose-length product (DLP) were compared. In addition, image quality and focal lesion depiction (n = 35) were qualitatively determined in the two groups. Unpaired t and Mann-Whitney tests were used for quantitative and qualitative assessment, respectively.
No significant difference in CT numbers of the abdominal aorta and pancreas was noted between the two groups. Mean DLP was 43% lower in the 320-detector group (675.4 mGy·cm) than in the 64-detector group (1187.8 mGy·cm) (P < .001). SNR of the abdominal aorta, pancreas, and abdominal wall fat on biphasic images was significantly lower in the 320-detector group than in the 64-detector group (P < .001). Image quality was acceptable in both groups and was slightly better in the 64-detector group for pancreatic phase axial images (P = .02) and arterial phase multiplanar reformatted images (P < .01). No significant difference was found in the depiction of pancreatic parenchyma, main pancreatic duct, focal pancreatic lesions, splanchnic arteries, or most of the small splanchnic arterial branches.
A 320-detector CT scan facilitates fast volumetric contrast-enhanced CT of the entire pancreas with acceptable image quality, even though SNR was significantly lower at 320-detector volumetric scanning.
前瞻性比较 320 层容积和 64 层螺旋 CT 胰腺成像在显示解剖结构、图像噪声和辐射剂量方面的效果。
本研究经机构审查委员会批准,并获得患者书面知情同意。共纳入 154 例患者(85 例男性,69 例女性;年龄 26-85 岁,平均 67 岁),均行双期(动脉期和胰腺期)对比增强 CT 检查,采用 320 层扫描仪,将患者随机分为 2 组:320 层组和 64 层组。获得双期轴位多平面重建图像和容积再现 CT 血管造影。比较两组患者腹主动脉、胰腺和腹部脂肪组织的 CT 值、信噪比(signal-to-noise ratio,SNR)和剂量长度乘积(dose-length product,DLP)。另外,在两组中对图像质量和局灶性病变显示(n=35)进行定性评估。采用独立样本 t 检验和 Mann-Whitney U 检验分别进行定量和定性评估。
两组患者腹主动脉和胰腺的 CT 值无显著差异。320 层组的平均 DLP 比 64 层组低 43%(320 层组:675.4 mGy·cm,64 层组:1187.8 mGy·cm,P<0.001)。320 层组双期图像的腹主动脉、胰腺和腹部脂肪 SNR 显著低于 64 层组(P<0.001)。两组患者的图像质量均可接受,64 层组胰腺期轴位图像(P=0.02)和动脉期多平面重建图像(P<0.01)的图像质量略好。胰腺实质、主胰管、局灶性胰腺病变、内脏动脉和大部分小内脏动脉分支的显示两组间无显著差异。
320 层 CT 容积扫描可快速进行整个胰腺的对比增强 CT 检查,即使在 320 层容积扫描时 SNR 显著降低,也可获得可接受的图像质量。