目的 探讨对比剂个性化在肝脏增强CT应用的图像质量及可重复性.方法 肝脏三期增强受检者以个性化方案扫描,评价图像质量及肝实质期强化效应可重复性.结果 192例受检者实际单位体重碘剂量(374.8±52.1)mgl/Kg,实际注射碘流率(1138.0±130.9)mgl/s,有效碘总量(21320.0±3017.7)mgl,肝脏EU肝实质期为(53.2±7.0)Hu.主动脉强化、动脉期时机、肝实质期强化满足诊断分别约89.06%、94.3%、97.9%;医师间主动脉强化(x2=3.333)与扫描时机(x2=1.833)、肝实质期强化效应(x2=7.667)评价未见显著差异(均P≥0.05),医师评价高度一致(kappa值分别为0.861,0.803,0.914,均P=0.000),样本均数与50Hu比较未见统计差异(t=1.745,P=0.083),变异系数为13.13%,其中16例受检者两次扫描肝实质EU分别为(49.8±6.4)Hu、(50.3±6.7)Hu,差值均数(-0.5000±2.8432)Hu与0比较未见统计差异(t=-0.703,P=0.493).结论 对比剂个性化扫描的肝脏图像质量优良、可重复性较好,易于推广应用.
Objective evaluate the image quality and its repeatability of contrast agent personalization in liver enhanced CT applications.Methods A total of 192 consecutive patients whom suspected liver disease were recruited and accepted tri-phase enhanced CT scans with a personalized Iodine contrast medium protocol prospectively,using a 64-MDCT scanner.Recording the actual unit weight iodine dose,effective total iodine dose,real injection rate.The image quality and the reproducibility was evaluated,and physician consistency was tested by Kappa coefficient or paired data MaNemar.Results A total of 192 subjects were included,of whom 109 males and 83 females,the actual unit weight iodine dose was(374.8±52.1)mgl/Kg,actual injection iodine flow rate was(1138.0±130.9)mgl/s,effective total iodine dose was(21320.0±3017.7)mgl.The measurement showed that the enhancement unit(EU)of hepatic parenchymal phase is(53.2±7.0)Hu.The evaluation showed that the proportion of aortic enhancement meeting the diagnosis was about 89.06%during arterial phase;the proportion of the scanning timing meeting the diagnosis was about 94.3%during the arterial phase timing;the proportion of liver EU meeting the diagnosis was about 97.9%during hepatic parenchymal phase.There was no significant difference in the evaluation of inter physician aortic enhancement(x2=3.333),scanning timing(x2=1.833),and hepatic parenchymal enhancement effect(x2=7.667)(P≥0.05).The image evaluation of two physicians were highly consistent(kappa values were 0.861,0.803,0.914,P=0.000),and there was no statistical difference between the single sample mean and 50Hu(t=1.745,P=0.083),the coefficient valiance meet 13.13%.Of them,16 subjects underwent initial and follow-up scans,with liver parenchymal EU values of(49.8±6.4)Hu and(50.3±6.7)Hu,respectively,and there was no significant statistical difference between the mean difference(-0.5000±2.8432)and zero(t=-0.703,P=0.493).Conclusion The personalized contrast agent scheme obtained not only a well-quality image in liver,but the good repeatability.This technology is easy to operable,and has high clinical promotion value.