宽体探测器CT胰腺轴位灌注“一站式”成像的可行性

目的 探讨Revolution CT胰腺轴位灌注"一站式"成像的可行性。方法 收集接受Revolution CT上腹部轴位CT灌注（CTP）扫描的患者13例（CTP组）,测量胰腺的CTP参数,提取最佳时期CTA及3期增强图像,并记录整个灌注期的辐射剂量。收集同期行全腹3期增强及CTA扫描者18例（对照组）,采用螺旋扫描模式。2组患者胰腺均无病变。评价2名观察者测得各CTP参数和对胰十二指肠上动脉（SPDA）图像主观评分的一致性。比较2组SPDA图像的主观评分和CTA图像SPDA以及3期增强图像胰腺的CT值、图像噪声、CNR和SNR。结果 2名观察者测得CTP参数一致性良好（ICC均>0.75）。灌注期有效辐射剂量为（24.52±0.01）mSv。2名观察者对2组CTA图像SPDA的主观评分结果一致性较好（Kappa=0.629、0.769）,2组评分中位数均为5分;CTP组SPDA的CT值、CNR、SNR均高于对照组（P均<0.05）。CTP组静脉期、平衡期的胰腺CT值、CNR、SNR均高于对照组（P均<0.05）。结论 Revolution CT胰腺轴位灌注"一站式"成像,在获得稳定的胰腺CTP定量数据的同时,可提取图像质量相仿甚至更佳的胰腺3期强化图像,并可获得更优质的胰周CTA图像,有很好的临床应用前景。

Feasibility of one-stop examination with wide detector CT for axial perfusion of pancreas

Objective To explore the feasibility of one-stop examination with Revolution CT for axial perfusion of normal pancreas. Methods Thirteen patients who received axial perfusion scan by one-stop examination with Revolution CT were analyzed as perfusion group. Two radiologists measured pancreatic CT perfusion (CTP) parameters independently and selected optimal phase for CTA and three phases of enhanced images. The effect dose (ED) was calculated. Eighteen patients who underwent abdominal enhanced CT and CTA with spiral scan were included as control group. Patients in both groups had no pancreatic disorders. The interobserver variation of CTP parameters was estimated. Two independent radiologists separated the superior pancreaticoduodenal artery (SPDA) image into 5 points according to image quality, and the consistency was assessed. The subjective points of SPDA image quality of two groups was compared. CT value, images noise, CNR and SNR of SPDA on CTA images and those of pancreas on three phases enhanced scan images between two groups were compared. Results ICC values of all CTP parameters were higher than 0.75. The ED of perfusion protocol was (24.52±0.01)mSv. The subjective image scores of SPDA on CTA images in both groups were both 5, the consistency was good (Kappa=0.629, 0.769). The CT value, CNR, and SNR of SPDA on CTA images of CTP group were higher than those of control group (all P<0.05). The CT value, CNR, and SNR of pancreas of CTP group were higher than those of control group in venous phase and balanced phase (all P<0.05). Conclusion The pancreatic CT one-stop examination can be performed by Revolution CT scanner with maximum detector width with acceptable radiation dose, from which pancreatic CT perfusion data, enhanced images with high quality and better CTA images can be extracted.