双能量CT直接增强法在双下肢静脉成像中的优势
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摘要
目的探讨双能量CT快速扫描对双侧下肢静脉直接增强(双侧下肢DE-DSCTV)的应用,以及直接增强法相对于间接增强法的优势。方法选择30例患有下肢静脉病变的患者,通过改进高压注射器的注射模式,进行双侧下肢静脉双能量CT直接增强扫描。通过后处理获取三维血管图像,与该名患者之前的间接增强法CTV图像进行对比。判断直接增强法对双侧下肢静脉造影的可行性,以及直接增强法DE-DSCTV是否更具有优势。结果 30例患者均获得对比度更高,更为清晰准确的图像,大大的提高了病灶检出率。结论双侧下肢静脉双能量CT直接增强法DE-DSCTV扫描是一种低辐射量,低造影剂量的检查方法。一次扫描就可以同时得到双侧下肢的直接增强图像。相对于间接增强法,直接增强法所获得的图像具有更高的对比度,更有利于病灶的检出,成像效果令人满意。
Objective To explore the application of rapid double-energy CT scan in the direct enhancement of bilateral lower limb veins(DE-DSCTV), and the advantages of the direct enhancement method relative to the indirect enhancement method.Methods Thirty patients with lower limb venous disease were selected. The dual-energy CT enhanced scan of bilateral lower extremities was performed by improving the injection mode of high-pressure syringe. 3D vascular images were obtained by post-processing and compared with the previous indirect enhancement CTV image of the same patient. Judging the feasibility of the direct method to enhance the venography of bilateral lower extremities, and whether the direct enhancement method DE-DSCTV is more advantageous. Results All 30 patients had higher contrast, clearer and more accurate images, which greatly improved the detection rate of lesions. Conclusion Bilateral lower extremities venous double energy CT direct enhanced CTV is a low dose and low contrast medium examination. The direct enhanced images of both lower extremities can be obtained simultaneously by one scan. Compared with the indirect enhancement method, the image obtained by the direct enhancement method has a higher contrast, which is more favorable for the detection of the focus, and the imaging effect is satisfactory.
Objective To explore the application of rapid double-energy CT scan in the direct enhancement of bilateral lower limb veins(DE-DSCTV), and the advantages of the direct enhancement method relative to the indirect enhancement method.Methods Thirty patients with lower limb venous disease were selected. The dual-energy CT enhanced scan of bilateral lower extremities was performed by improving the injection mode of high-pressure syringe. 3D vascular images were obtained by post-processing and compared with the previous indirect enhancement CTV image of the same patient. Judging the feasibility of the direct method to enhance the venography of bilateral lower extremities, and whether the direct enhancement method DE-DSCTV is more advantageous. Results All 30 patients had higher contrast, clearer and more accurate images, which greatly improved the detection rate of lesions. Conclusion Bilateral lower extremities venous double energy CT direct enhanced CTV is a low dose and low contrast medium examination. The direct enhanced images of both lower extremities can be obtained simultaneously by one scan. Compared with the indirect enhancement method, the image obtained by the direct enhancement method has a higher contrast, which is more favorable for the detection of the focus, and the imaging effect is satisfactory.
引文
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[13]夏巍,吴晶涛,尹肖睿,等.低管电压法与低管电流法在降低多层螺旋CT下肢静脉成像辐射剂量中的对比研究[J].中华放射学杂志,2013,47(4):368-70.
[14]秦维昌,刘传亚,元恒涛.重视医用x线检查低剂量成像方法学的研究[J].中华放射学杂志,2008,42(10):1013-4.
[15]李鹏飞,龚金山.256层螺旋CT间接法静脉造影在下肢静脉疾病中的价值[J].医学影像学杂志,2015,25(8):1413-5.
[16]Garcia JA,Agostoni P,Green NE,et al.Rotational vs standard coronary angiography:an image content analysis[J].Catheter Cardio-vase Intery,2009,7(3):756-61.
[17]彭碧荣,周萍丽,徐佳.直接法及间接法在下肢CT静脉成像中的应用比较[J].武汉大学学报,2017,38(1):65-9.
[18]张卫国,刘佳萍,刘敏,等.CT下肢静脉造影检查中应用不同方法注入对比剂的研究[J].中国病案,2014,15(11):77-9.
[19]Baldt MM,Zontsich T,Stumpflen A,et al.Deep venous thrombosis of the lower extremity:efficcacy of spiral CTvenography compared with conventional venography in diagnosis[J].Radiology,1996,200(2):423-8.
[20]严由伦,李荣,姜永宏,等.螺旋CT在肺动脉及下肢静脉联合检查中的成像方法[J].实用放射学杂志,2012,28(5):775-9.
[21]曹洁玉,蒋双兰,刘建新,等.直接法多层螺旋CT静脉造影诊断下肢深静脉血栓[J].实用医学影像杂志,2014,15(1):1-3.
[2]Das M,Mühlenbruch G,Mahnken AH,et a1.Optimized image reconstruction for detection of deep venous thrombosis at multidetector-row CT venography[J].Eur Radiol,2006,16(3):269-75.
[3]于龙,姜辉.多层螺旋CT下肢静脉血管造影及临床应用分析[J].世界最新医学信息文摘,2016,16(53):166-75.
[4]易文芳,武志峰,鄂林宁,等.双源CT直接法下肢静脉成像对深静脉血栓的诊断价值[J].中国临床医学影像杂志,2015,26(7):518-22.
[5]Bae KT,Seeck BA,Hildebolt CF,et a1.Contrast enhancement in cardiovascular MDCT:effect of body weight,height,body surface area,body mass index and obesity[J].Am J Roentgenol,2008,190(7):777-84.
[6]Lee W,Chung JW,Yin YH,et al.Three-dimensional CTvenography of varicose veins of the lower extremity:image quality and comparison with Doppler sonography[J].Am J Roentgenol,2008,191(4):1186-91.
[7]姜建威,殷允娟,常军,等.直接法CT静脉造影对下肢静脉曲张的诊断价值[J].中国医学影像学杂志,2013,21(11):825-8.
[8]王绍娟,王利伟,顾建平,等.双源CT双向法静脉造影在下肢深静脉血栓中的初步应用[J].中国CT和MRI杂志,2015,13(5):32-4.
[9]JCS Joint Working Group.Guidelines for the diagnosis,treatment and prevention of pulmonary thromboembolism and deep vein thrombosis(JCS 2009)[J].Circ J,2011,75(5):1258-81.
[10]李惠民,于红,肖湘生,等.16层CT胸部血管成像Z轴调制低剂量研究[J].中华放射学杂志,2011,45(7):762-5.
[11]Gareia JA,Chen SY,Messenger JC,et al.Intial clinical experience of selecitve coronary angiography using one prolonged injetion and a 180 degrees rotational trajectory[J].Catheter Cardiovasc Interv,2007,70(2):190-6.
[12]Bauer RW,Schell B,Beeres M,et al.High-pitch dual-source computed tomography angiography in freely breathing patients[J].J Thorac Imaging,2012,27(6):376-81.
[13]夏巍,吴晶涛,尹肖睿,等.低管电压法与低管电流法在降低多层螺旋CT下肢静脉成像辐射剂量中的对比研究[J].中华放射学杂志,2013,47(4):368-70.
[14]秦维昌,刘传亚,元恒涛.重视医用x线检查低剂量成像方法学的研究[J].中华放射学杂志,2008,42(10):1013-4.
[15]李鹏飞,龚金山.256层螺旋CT间接法静脉造影在下肢静脉疾病中的价值[J].医学影像学杂志,2015,25(8):1413-5.
[16]Garcia JA,Agostoni P,Green NE,et al.Rotational vs standard coronary angiography:an image content analysis[J].Catheter Cardio-vase Intery,2009,7(3):756-61.
[17]彭碧荣,周萍丽,徐佳.直接法及间接法在下肢CT静脉成像中的应用比较[J].武汉大学学报,2017,38(1):65-9.
[18]张卫国,刘佳萍,刘敏,等.CT下肢静脉造影检查中应用不同方法注入对比剂的研究[J].中国病案,2014,15(11):77-9.
[19]Baldt MM,Zontsich T,Stumpflen A,et al.Deep venous thrombosis of the lower extremity:efficcacy of spiral CTvenography compared with conventional venography in diagnosis[J].Radiology,1996,200(2):423-8.
[20]严由伦,李荣,姜永宏,等.螺旋CT在肺动脉及下肢静脉联合检查中的成像方法[J].实用放射学杂志,2012,28(5):775-9.
[21]曹洁玉,蒋双兰,刘建新,等.直接法多层螺旋CT静脉造影诊断下肢深静脉血栓[J].实用医学影像杂志,2014,15(1):1-3.