Huang Linjie, Jiang Shengchen, Ruan Fengqiu, Long Liling
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Med Sci Monit. 2025 Mar 26;31:e947391. doi: 10.12659/MSM.947391.
BACKGROUND Portal vein tumor thrombus (PVTT) is a critical complication in hepatocellular carcinoma (HCC). Spectral computed tomography (CT) is increasingly used to enhance the diagnosis of such conditions. This study examines the effect of different iodine concentrations in contrast media on portal vein image quality and iodine intake using spectral CT to improve imaging techniques. MATERIAL AND METHODS A total of 88 patients were divided into 3 groups based on iodine concentration in contrast media: Group A (300 mgI/mL, n=30), Group B (320 mgI/mL, n=28), and Group C (350 mgI/mL, n=30). Each underwent a GSI scan with an injection rate of 4.5 mL/s and a dose of 1.5 mL/kg. Eleven sets of 40-140 keV images were reconstructed for each group. CT value, image noise, contrast noise ratio (CNR), signal-to-noise ratio (SNR), and subjective image scores of intra-hepatic and extra-hepatic portal veins were analyzed. Optimal monochromatic levels and iodine intake were assessed for each group. RESULTS The optimal monochromatic level for portal veins was between 80 keV-110 keV across groups. Significant differences were noted in CT values and image noise among groups (P<0.05), but not in CNR, SNR, or subjective scores (P>0.05). Iodine intake was reduced by 21.29% in Group A and 14.60% in Group B compared to Group C. CONCLUSIONS GSI scans with low-concentration contrast media effectively reduce iodine intake while maintaining image quality during liver CT-enhanced scans.
背景 门静脉肿瘤血栓（PVTT）是肝细胞癌（HCC）的一种关键并发症。光谱计算机断层扫描（CT）越来越多地用于增强对此类病症的诊断。本研究使用光谱CT检查不同碘浓度的造影剂对门静脉图像质量和碘摄入量的影响，以改进成像技术。
材料与方法 总共88例患者根据造影剂中的碘浓度分为3组：A组（300 mgI/mL，n = 30）、B组（320 mgI/mL，n = 28）和C组（350 mgI/mL，n = 30）。每组均以4.5 mL/s的注射速率和1.5 mL/kg的剂量进行GSI扫描。每组重建11组40 - 140 keV图像。分析肝内和肝外门静脉的CT值、图像噪声、对比噪声比（CNR）、信噪比（SNR）以及主观图像评分。评估每组的最佳单色水平和碘摄入量。
结果 各组门静脉的最佳单色水平在80 keV - 110 keV之间。各组之间CT值和图像噪声存在显著差异（P<0.05），但CNR、SNR或主观评分无显著差异（P>0.05）。与C组相比，A组碘摄入量减少了21.29%，B组减少了14.60%。
结论 在肝脏CT增强扫描中，使用低浓度造影剂的GSI扫描可有效减少碘摄入量，同时保持图像质量。
