Murphy Andrew, Cheng Jeffrey, Pratap Jit, Redman Renae, Coucher John
Department of Medical Imaging, British Columbia Children's Hospital, Vancouver, Canada; Department of Medical Imaging, St Paul's Hospital, Vancouver, Canada; Faculty of Health Sciences, The University of Sydney, Discipline of Medical Radiation Sciences, Cumberland Campus, Lidcombe, Australia.
Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia.
J Med Imaging Radiat Sci. 2019 Mar;50(1):62-67. doi: 10.1016/j.jmir.2018.10.009. Epub 2018 Dec 4.
Optimal opacification of the pulmonary vasculature is a fundamental factor of a diagnostic quality computed tomography pulmonary angiogram (CTPA). This retrospective study examined the feasibility of utilising a noise-optimised monoenergetic reconstruction of the dual-energy computed tomography pulmonary angiogram (DE-CTPA) as an additional protocol to increase vessel opacification.
The study involved a retrospective analysis of 129 patients, 69 males (average age 58 years), 60 females (average age 56 years) who underwent a DE-CTPA at a tertiary referral hospital. Linear blended 120 kilovoltage (kV) images (LB120) dual-energy (DE) data sets (50% 100 kV and 50% 140 kV) were compared to noise-optimised virtual monoenergetic image reconstruction (VMI+) at 40 kiloelectron volts (VMI+40). The attenuation of the pulmonary trunk measured in Hounsfield units (HU) between the equivalent axial slices of the LB120 data set and the VMI+40 data set underwent statistical analysis via a Wilcoxon paired-sample test.
VMI+40 (1161.500 HU) yielded a statistically significant increase in median attenuation within the pulmonary trunk compared to the LB120 (304.400 HU), with a median difference between monoenergetic reconstruction and standard dual energy of data sets of 827.5 HU (P < .001).
VMI+40 of the DE-CTPA scan demonstrates a statistically significant increase in vessel attenuation in all cases and may have utility in reducing the rates of indeterminate or repeated studies.
肺部血管的最佳显影是诊断性计算机断层扫描肺血管造影（CTPA）的一个基本要素。本回顾性研究探讨了将双能量计算机断层扫描肺血管造影（DE-CTPA）的噪声优化单能量重建作为增加血管显影的附加方案的可行性。
该研究对一家三级转诊医院接受DE-CTPA检查的129例患者进行了回顾性分析，其中男性69例（平均年龄58岁），女性60例（平均年龄56岁）。将线性混合120千伏（kV）图像（LB120）双能量（DE）数据集（50% 100 kV和50% 140 kV）与40千电子伏特的噪声优化虚拟单能量图像重建（VMI+）（VMI+40）进行比较。通过Wilcoxon配对样本检验对LB120数据集和VMI+40数据集等效轴位切片之间以亨氏单位（HU）测量的肺动脉主干衰减进行统计分析。
与LB120（304.400 HU）相比，VMI+40（1161.500 HU）使肺动脉主干内的中位数衰减有统计学意义的增加，单能量重建与数据集标准双能量之间的中位数差异为827.5 HU（P <.001）。
DE-CTPA扫描的VMI+40在所有病例中均显示血管衰减有统计学意义的增加，可能有助于降低不确定或重复检查的发生率。
