能量CT虚拟单能量图像与碘图在腹部实质性脏器疾病诊断中的应用进展

doi:10.16150/j.1671-2870.2024.04.015

摘要/Abstract

摘要：

计算机断层扫描(computed tomograhy，CT)是目前临床常用的影像学检查手段之一，但其软组织分辨率不够高，对于部分病灶的检出以及鉴别存在困难，且在定量评估方面尚显不足。能量CT成像拥有多参数、多维度、定量成像，可量化反映组织的成分特征和血供特点等诸多优势。通过高、低能量两套数据计算，模拟出单一KeV能量的图像，即虚拟单能量图像（virtual monoenergetic images, VMI）。本文综述了能量CT中VMI与碘密度图技术在腹部实质性脏器疾病病灶检出及鉴别诊断方面应用的研究，总结了VMI及碘密度图在肝脏、胰腺病灶检出方面的研究进展。对于小肝癌的检出，相较于常规CT，VMI获得的关键影像学特征的置信度从52.4%提升至68.8%。在胰腺方面，对于胰腺内分泌肿瘤，VMI可将病灶检出率从常规CT的84.6%提升至92.3%。此外，在鉴别诊断方面，VMI与碘密度图的相关研究也有着诸多进展，在肾囊肿分型、小肝癌与小肝血管瘤的鉴别以及胰腺浆液性与黏液性囊腺瘤的鉴别等研究中，VMI均显示出了更好的诊断效能。在此进展的基础上，本文对能量CT VMI与碘密度图在腹部实质性脏器中的应用前景进行了展望。

关键词: 能量CT, 虚拟单能量图像, 碘密度图, 腹部, 诊断

Abstract:

Computed tomography (CT) is one of the most commonly used examination methods in clinical practice, but its resolution for soft-tissue is not high enough, making it difficult to detect and identify some lesions, and it is insufficient in quantitative assessment. The advantages of spectral CT imaging are multi-parameter, multi-dimensional and quantitative imaging, which reflects the compositional characteristics of tissues and the characteristics of blood supply. It can simulate images of a single KeV energy, through two sets of high-energy and low-energy data, namely virtual monoenergetic images (VMI). In this review, the current problems in the use of VMI and iodine maps in lesion detection and differentiating diagnosis of abdominal diseases were concluded. The progress in detection of liver and pancreas lesion were pointed out. For example, the confidence level was raised from 52.4 to 68.8 in detection of small hepatocellular carcinoma by using VMI. In the pancreas, compared with normal CT, detection rate of VMI for endocrine tumor in pancreas was raised from 84.6% to 92.3%. What’s more, in terms of differential diagnosis, there have been many advances in the research on VMI and iodine density maps, and higher efficiency in differentiating diagnosis has been obtained in the classification of kidney cyst, differentiation between small hepatocellular carcinoma and small hepatic hemangioma, and differentiation of serous and mucinous cystadenoma in pancreas. Based on current progress, the future of VMI and iodine maps in abdominal diseases is prospected.

Key words: Spectral CT, Virtual Monoenergetic Imaging, Iodine Map, Abdomen, Diagnosis

中图分类号:

R445.3
R735

张天翼, 严福华. 能量CT虚拟单能量图像与碘图在腹部实质性脏器疾病诊断中的应用进展[J]. 诊断学理论与实践, 2024, 23(04): 452-456.

ZHANG Tianyi, YAN Fuhua. Advances in the diagnosis of abdominal disease based on virtual monoenergetic imaging and iodine map of spectral CT[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(04): 452-456.

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