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目的:评价双源CT双能量虚拟平扫(VNCT)技术在临床直肠癌诊断中的可行性。方法:对49例经肠镜活检确诊为直肠癌的患者行盆腔常规平扫及动脉期、门脉期双能量扫描,采用Liver VNC软件分别得到直肠癌病灶、髂腰肌、皮下脂肪、髂外动脉动脉期及门脉期的VNCT图像,分别测量并比较常规平扫及动脉期、门脉期VNCT这3组图像中病灶的平均CT值、图像噪声、图像质量和辐射剂量等方面的差异。结果:常规平扫与VNCT图中所测得的组织平均CT值除髂外动脉、皮下脂肪外差异均无统计学意义(P>0.05),VNCT的图像噪声低于常规平扫而信噪比高于常规平扫(P<0.01),但其图像质量略低于常规平扫(P<0.01),不过仍可达到诊断需求。动脉期VNCT为(3.96±0.46)分,门脉期VNCT为(3.80±0.54)分,省略常规平扫降低的辐射剂量为(31.49±1.47)%。结论:VNCT在直肠癌术前检查中可减低辐射剂量,且不影响诊断,具有潜在临床应用价值。
Objective: To evaluate the feasibility of dual-source CT dual-energy virtual scan (VNCT) in the diagnosis of clinical rectal cancer. Methods: Forty-nine patients diagnosed with rectal cancer by enteroscopy were performed conventional pelvic biopsy and arterial phase and portal venous phase dual energy scans. Liver VNC software was used to obtain rectal cancer lesions, iliopsoas muscle, subcutaneous fat, Arterial and portal venous phase VNCT images were measured and compared conventional plain and arterial phase, portal venous phase VNCT lesions in these three groups average CT value, image noise, image quality and radiation dose differences . Results: There was no significant difference in average CT value between conventional plain scan and VNCT images except for the external iliac artery and subcutaneous fat (P> 0.05). The image noise of VNCT was lower than that of conventional plain scan and signal to noise ratio (P <0.01), but the image quality was slightly lower than that of conventional plain scan (P <0.01), but the diagnostic needs were still met. The VNCT in arterial phase was (3.96 ± 0.46) min and the VNCT in portal phase was (3.80 ± 0.54) min, which was 31.49 ± 1.47%. Conclusion: VNCT can reduce the radiation dose in the preoperative examination of rectal cancer, and does not affect the diagnosis, which has potential clinical value.