目的 分析双能量CT虚拟单能量成像(Mono+)技术联合个体化对比剂注射方案在诊断糖尿病下肢动脉粥样硬化中的应用。方法 选取102例糖尿病疑似下肢动脉粥样硬化患者，均接受双能量CT Mono+技术联合个体化对比剂注射方案，根据个体化对比剂注射方案分为A组(1。5 m L/kg)34例、B组(1。2 m L/kg)34例、C组(1。0 m L/kg)34例。所有患者行双源CT扫描，并以1周内超声多普勒血管成像扫描结果作为金标准，评估个体化对比剂注射方案下双能量CT Mono+技术与超声多普勒血管成像诊断结果的一致性。结果 B组患者的腹髂段、股腘段和膝下段的CT值、信噪比、对比噪声比高于A组、C组(P<0。05)，C组患者股腘段和膝下段的CT值高于A组(P<0。05)。102例糖尿病患者中，经超声多普勒血管成像诊断，确诊84例存在下肢动脉粥样硬化。A组、B组、C组诊断下肢动脉粥样硬化的阳性预测值分别为93。90%、97。65%、93。98%;阴性预测值分别为65。00%、94。14%、68。42%;与超声多普勒血管成像诊断结果的一致性分别为0。690、0。897、0。715。B组诊断准确性高于A组、C组(P<0。05)。结论 双能量CT Mono+技术联合个体化对比剂注射方案在诊断糖尿病下肢动脉粥样硬化中的效能良好，且尤以1。2 m L/kg对比剂注射方案的下肢动脉显像质量最佳。
Differential analysis of contrast agent injection volume for the diagnosis of lower extremity artery atherosclerosis in diabetes patients
Objective To analyze the application of dual-energy CT virtual monoenergetic imaging(Mono+)technology com-bined with personalized contrast agent injection protocols in the diagnosis of lower extremity artery atherosclerosis in diabetes patients.Methods A total of 102 diabetes patients with suspected lower extremity artery atherosclerosis were selected.All patients received dual-energy CT Mono+technology combined with personalized contrast agent injection protocols.Based on personalized contrast agent injection protocols,the patients were divided into group A(34 cases,1.5 m L/kg),group B(34 cases,1.2 m L/kg),and group C(34 cases,1.0 m L/kg).All patients underwent dual-source CT scanning,and the results of ultrasound Doppler vascular imaging within one week were used as the gold standard to evaluate the consistency between dual-energy CT Mono+technology and ultra-sound Doppler vascular imaging under personalized contrast agent injection protocols.Results The CT values,signal-to-noise ratio and contrast-to-noise ratio of the abdominal iliac segment,femoral popliteal segment and lower knee segment in group B were higher than those in group A and group C(P<0.05).The CT values of the femoral popliteal and lower knee segments in group C were higher than those in group A(P<0.05).Among the 102 diabetes patients,84 were diagnosed with lower extremity artery athero-sclerosis confirmed by ultrasound Doppler vascular imaging.The positive predictive values for diagnosing lower extremity artery ath-erosclerosis in groups A,B,and C were 93.90%,97.65%,and 93.98%,respectively.The negative predictive values were 65.00%,94.14%,and 68.42%,respectively.The consistency with ultrasound Doppler vascular imaging was 0.690,0.897,and 0.715,respec-tively.Group B exhibited a higher diagnostic accuracy than groups A and C(P<0.05).Conclusion The dual-energy CT Mono+technology combined with personalized contrast agent injection protocols demonstrate good efficacy in diagnosing lower extremity artery atherosclerosis in diabetes patients,with the best imaging quality observed with the contrast agent injection protocol of 1.2 m L/kg.
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