利用能谱探测器 CT 对碘的出血进行鉴别：一项体模研究。
Differentiation of Hemorrhage from Iodine Using Spectral Detector CT: A Phantom Study.
机构信息
From the Departments of Radiology (S.V.H., N.G.H., K.R.L., R.K., P.R., D.J.)
Case Western Reserve University School of Medicine (S.V.H., N.G.H., K.R.L., R.K., B.R., P.R., D.J.), Cleveland, Ohio.
出版信息
AJNR Am J Neuroradiol. 2018 Dec;39(12):2205-2210. doi: 10.3174/ajnr.A5872. Epub 2018 Nov 8.
BACKGROUND AND PURPOSE
Conventional CT often cannot distinguish hemorrhage from iodine extravasation following reperfusion therapy for acute ischemic stroke. We investigated the potential of spectral detector CT in differentiating these lesions.
MATERIALS AND METHODS
Centrifuged blood with increasing hematocrit (5%-85%) was used to model hemorrhage. Pure blood, blood-iodine mixtures (75/25, 50/50, and 25/75 ratios), and iodine solutions (0-14 mg I/mL) were scanned in a phantom with attenuation ranging from 12 to 75 HU on conventional imaging. Conventional and virtual noncontrast attenuation was compared and investigated for correlation with calculation of relative virtual noncontrast attenuation. Values for all investigated categories were compared using the Mann-Whitney test. Sensitivity and specificity of virtual noncontrast, relative virtual noncontrast, conventional CT attenuation, and iodine quantification for hemorrhage detection were determined with receiver operating characteristic analysis.
RESULTS
Conventional image attenuation was not significantly different among all samples containing blood ( > .05), while virtual noncontrast attenuation showed a significant decrease with a decreasing blood component ( < .01) in all blood-iodine mixtures. Relative virtual noncontrast values were significantly different among all investigated categories ( < .01), with correct hemorrhagic component size estimation for all categories within a 95% confidence interval. Areas under the curve for hemorrhage detection were 0.97, 0.87, 0.29, and 0.16 for virtual noncontrast, relative virtual noncontrast, conventional CT attenuation, and iodine quantification, respectively. A ≥10-HU virtual noncontrast, ≥20-HU virtual noncontrast, ≥40% relative virtual noncontrast, and combined ≥10-HU virtual noncontrast and ≥40% relative virtual noncontrast attenuation threshold had a sensitivity/specificity for detecting hemorrhage of 100%/23%, 89%/95%, 100%/82%, and 100%/100%, respectively.
CONCLUSIONS
Spectral detector CT can accurately differentiate blood from iodinated contrast in a phantom setting.
背景与目的
常规 CT 通常无法区分急性缺血性脑卒中再灌注治疗后出血与碘外渗。我们研究了光谱探测器 CT 在区分这些病变中的潜力。
材料与方法
使用离心血来模拟不同血细胞比容（5%-85%）的出血情况。纯血、血碘混合物（75/25、50/50 和 25/75 比例）和碘溶液（0-14mgI/mL）在衰减范围为 12-75HU 的体模中进行扫描，在常规成像上。比较常规和虚拟非增强衰减，并研究其与相对虚拟非增强衰减计算的相关性。使用曼-惠特尼 U 检验比较所有研究类别的值。使用受试者工作特征曲线分析确定虚拟非增强、相对虚拟非增强、常规 CT 衰减和碘定量对出血检测的敏感性和特异性。
结果
含有血液的所有样本的常规图像衰减均无显著差异（>0.05），而虚拟非增强衰减则随着血液成分的减少而显著降低（<0.01）。所有研究类别之间的相对虚拟非增强值均有显著差异（<0.01），所有类别的出血成分大小估计均在 95%置信区间内。出血检测的曲线下面积分别为虚拟非增强、相对虚拟非增强、常规 CT 衰减和碘定量的 0.97、0.87、0.29 和 0.16。虚拟非增强≥10HU、虚拟非增强≥20HU、相对虚拟非增强≥40%和联合虚拟非增强≥10HU 和相对虚拟非增强≥40%衰减阈值的敏感性/特异性分别为 100%/23%、89%/95%、100%/82%和 100%/100%。
结论
光谱探测器 CT 可以在体模环境中准确区分血液和碘化造影剂。
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