摘要
目的:探讨双层探测器光谱CT单能量技术对克罗恩病小肠造影肠壁强化的应用价值.方法:获取 2023年 1月至 2024年 7月在南京医科大学附属第一医院 43例克罗恩患者光谱CT小肠造影图像,重建获得 40～140keV单能级及常规混合能量的图像,采用单因素方差分析对 40～140keV单能级及常规混合能量的CT值、噪声、SNR、CNR进行评价;采用 5分法对图像质量进行主观评价,采用秩和检验分析结果,克罗恩病活动性影像学特征采用配对χ2检验.结果:各单能级图像与混合能量组图像的CT值、噪声、SNR、CNR总体差异均具有统计学意义.随着单能级能量的升高,图像的CT值、噪声、SNR、CNR均递减,其中 40keV的各项指标最高.检验组间两两比较发现,40keV图像的CT值、噪声、SNR、CNR与其他组均有统计学差异.70keV与混合能量组图像的CT值、噪声、SNR、CNR无统计学差异.40keV图像的质量主观评分高于混合能量组,差异具有统计学意义,混合能量组和 40keV单能级图像评估活动性克罗恩病不具有统计学差异.结论:40keV单能级小肠造影的图像质量总体评分高于常规混合能量组图像,可以提高和优化对小肠克罗恩病的诊断,可以在临床应用中推广.
Abstract
Objective:To investigate the application of a double-layer detector spectral computed tomography(CT)single-energy technology for intestinal wall enhancement in Crohn's disease enterography.Methods:Data from 43 patients with Crohn's disease who underwent enterography using spectral CT between January 2023 and July 2024 were retrospectively collected.The 40～140 keV single level and conventional mixed energy images were reconstructed,and the CT value,noise,signal to noise ratio(SNR),and contrast to noise ratio(CNR)of the 40～140 keV single level and conventional mixed energy images were objectively evaluated using one-way ANOVA.The image quality was evaluated subjectively using the five point method,and the results were analyzed using the rank sum test.Differences in imaging features of Crohn's disease activity were determined using the paired χ2 test.Results:Significant differences were observed in the CT value,noise,SNR,and CNR between the single-level and mixed-energy image groups.With an increase in single-level energy,the CT value,noise,SNR,and CNR of all images decreased,and each index was the highest at 40 keV.Pair-to-group comparisons showed that the CT value,noise,SNR,and CNR of the 40 keV images were significantly different from those of the other groups.A significant difference was absent in the CT value,noise,SNR,or CNR between the 70 keV and mixed energy image groups.The subjective score of the 40 keV image group was significantly higher than that of the mixed-energy image group.A statistical difference was absent between the mixed energy and 40 keV single-level image groups in the assessment of active Crohn's disease.Conclusion:The overall image quality score of 40 keV single level enterocardiography is higher than that of conventional mixed-energy images,and therefore can improve and optimize the diagnosis of small bowel Crohn's disease and be popularized in clinical applications.
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