双源与单源能谱 CT 诊断急性肺动脉栓塞的对比研究。
Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism.
机构信息
Institute of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.
出版信息
Rofo. 2021 Apr;193(4):427-436. doi: 10.1055/a-1245-0035. Epub 2020 Oct 1.
PURPOSE
Comparison of dual-source dual-energy CT (DS-DECT) and split-filter dual-energy CT (SF-DECT) regarding image quality and radiation dose in patients with suspected pulmonary embolism.
MATERIALS AND METHODS
We retrospectively analyzed pulmonary dual-energy CT angiography (CTPA) scans performed on two different CT scanners in 135 patients with suspected pulmonary embolism (PE). Scan parameters for DS-DECT were 90/Sn150 kV (n = 68 patients), and Au/Sn120 kV for SF-DECT (n = 67 patients). The iodine delivery rate was 1400 mg/s in the DS-DECT group vs. 1750 mg/s in the SF-DECT group. Color-coded iodine distribution maps were generated for both protocols. Objective (CT attenuation of pulmonary trunk [HU], signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR]) and subjective image quality parameters (two readers [R], five-point Likert scale), as well as radiation dose parameters (effective radiation dose, size-specific dose estimations [SSDE]) were compared.
RESULTS
All CTPA scans in both groups were of diagnostic image quality. Subjective CTPA image quality was rated as good or excellent in 80.9 %/82.4 % (R1 / R2) of DS-DECT scans, and in 77.6 %/76.1 % of SF-DECT scans. For both readers, the image quality of split-filter iodine distribution maps was significantly lower (p < 0.05) with good or excellent ratings in only 43.3 %/46.3 % (R1 / R2) vs. 83.8 %/88.2 % for maps from DS-DECT. The HU values of the pulmonary trunk did not differ between the two techniques (p = n. s.), while both the SNR and CNR were significantly higher in the split-filter group (p < 0.001; p = 0.003). Both effective radiation dose (2.70 ± 1.32 mSv vs. 2.89 ± 0.94 mSv) and SSDE (4.71 ± 1.63 mGy vs. 5.84 ± 1.11 mGy) were significantly higher in the split-filter group (p < 0.05).
CONCLUSION
The split-filter allows for dual-energy imaging of suspected pulmonary embolism but is associated with lower iodine distribution map quality and higher radiation dose.
KEY POINTS
· The split-filter allows for dual-energy data acquisition from single-source single-layer CT scanners.. · Compared to the assessed dual-source dual-energy system, split-filter dual-energy imaging of a suspected pulmonary embolism is associated with lower iodine distribution map quality and higher radiation dose.. · Both the split-filter and the dual-source scanner provide diagnostic image quality in CTPA..
CITATION FORMAT
· Petritsch B, Pannenbecker P, Weng AM et al. Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism. Fortschr Röntgenstr 2021; 193: 427 - 436.
目的
比较双源双能量 CT（DS-DECT）和分体式滤线栅双能量 CT（SF-DECT）在疑似肺动脉栓塞（PE）患者中的图像质量和辐射剂量。
材料和方法
我们回顾性分析了在两台不同 CT 扫描仪上进行的 135 例疑似 PE 患者的肺部双能量 CT 血管造影（CTPA）扫描。DS-DECT 组的扫描参数为 90/Sn150kV（n=68 例），SF-DECT 组为 Au/Sn120kV（n=67 例）。DS-DECT 组碘输送率为 1400mg/s，SF-DECT 组为 1750mg/s。为两种方案生成彩色碘分布图。比较了客观（肺动脉主干 CT 衰减值[HU]、信噪比[SNR]、对比噪声比[CNR]）和主观图像质量参数（两位读者[R]、五分制 Likert 量表）以及辐射剂量参数（有效辐射剂量、体型特异性剂量估计值[SSDE]）。
结果
两组的所有 CTPA 扫描均具有诊断性图像质量。DS-DECT 扫描中，80.9%/82.4%（R1/R2）的主观 CTPA 图像质量评为良好或优秀，SF-DECT 扫描中为 77.6%/76.1%。对于两位读者，分体式滤线栅碘分布图的图像质量明显较低（p<0.05），良好或优秀的评分仅为 43.3%/46.3%（R1/R2），而 DS-DECT 的评分为 83.8%/88.2%。两种技术的肺动脉主干 HU 值无差异（p=ns.），而 SNR 和 CNR 均明显更高（p<0.001；p=0.003）。分体式滤线栅组的有效辐射剂量（2.70±1.32mSv 比 2.89±0.94mSv）和 SSDE（4.71±1.63mGy 比 5.84±1.11mGy）均显著更高（p<0.05）。
结论
分体式滤线栅允许对疑似 PE 进行双能量成像，但与碘分布图质量较低和辐射剂量较高有关。
关键点
·分体式滤线栅允许从单源单层 CT 扫描仪进行双能量数据采集。
·与评估的双源双能系统相比，疑似肺动脉栓塞的分体式滤线栅双能成像与较低的碘分布图质量和较高的辐射剂量相关。
·两种分体式滤线栅和双源扫描仪均在 CTPA 中提供诊断性图像质量。
引文格式
Petritsch B, Pannenbecker P, Weng AM et al. Comparison of Dual- and Single-Source Dual-Energy CT for Diagnosis of Acute Pulmonary Artery Embolism. Fortschr Röntgenstr 2021; 193: 427-436.
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