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目的探讨宝石能谱CT单能量成像在显示乏血供肝癌病灶中的使用价值。方法运用宝石能谱CT对34例乏血供肝癌患者进行能谱扫描,对原始数据进行常规混合能量重建(140 kVp)和单能量重建(65 keV),在GE AW4.4工作站上通过能谱浏览器(GSI Viewer)分别选用混合能量图像和单能量图像对同层面病灶进行观察,观察病灶的数目、病灶与周边正常肝组织的对比(CT值差值)、背景噪声、对比噪声比和主观评分,并做配对t检验。结果在同一层面上单能图像发现的病灶数目明显多于混合能量图像。34例患者中仅有12例结果一致,22例单能图像显示病灶数目多于混合能量图像。单能与混合能图像中病灶与正常肝组织间的对比、对比噪声比及主观评分分别为(21.19±15.23)和(11.13±10.09)、(1.53±0.88)和(0.88±0.68)、(4.32±0.65)和(3.7±0.53),各项指标间的差异有统计学意义(P<0.01),图像背景噪声为(14.02±2.08)和(13.64±2.07),差异无统计学意义。结论宝石能谱CT GSI模式扫描重建65 keV单能图像可明显提高乏血供肝癌的检出率。
Objective To explore the value of single energy imaging of gem energy spectrum CT in the display of liver cancer with deficiency of blood. Methods 34 patients with hepatocellular carcinoma without blood supply were scanned by gem energy spectrum CT. The raw data were reconstructed by conventional hybrid energy (140 kVp) and single energy reconstruction (65 keV). The energy spectrum was analyzed by GE AW4.4 workstation. (GSI Viewer) were selected mixed energy images and single energy images of the same level lesions were observed, the number of lesions were observed lesions and the surrounding normal liver tissue (CT value difference), background noise, contrast noise ratio and subjective Score, and do paired t test. Results In the same level, the number of lesions found in the uni-energy images was significantly more than that of the mixed energy images. Only 12 of 34 patients had the same result, and 22 of them showed more lesions than mixed energy images. The contrast and subjective scores of lesions and normal liver tissues in single energy and mixed energy images were (21.19 ± 15.23) and (11.13 ± 10.09), (1.53 ± 0.88) and (0.88 ± 0.68) and (4.32 ± 0.65) and (3.7 ± 0.53) respectively. There was a significant difference between each index (P <0.01). The background noise of the images was (14.02 ± 2.08) and (13.64 ± 2.07) respectively, with no significant difference. Conclusions Gemstone ESCT scan with GSI mode can reconstruct 65 keV monoenergetic images.