能谱CT单能量成像及金属伪影削减算法在肝硬化门静脉高压TIPS术后血管成像的应用

摘要/Abstract

摘要： 目的探讨能谱CT单能量成像及金属伪影削减算法(MAR)在肝硬化门静脉高压经颈静脉肝内门体分流术(TIPS)后血管成像的应用价值。方法选取苏州大学附属第二医院2018年5月至2019年5月收治的肝硬化门静脉高压患者127例,所有患者入院后均接受TIPS治疗,并在治疗后1个月行能谱CT单能量成像检查,在检查结束后以MAR法对图像进行处理。计算60 keV、120 keV、120 kV-like、60 keV+120 keV、120 kV-like+keV图像的伪影指数(AI),随后由两名经验丰富的放射科医师进行阅片,并以5级评分法对图像的解剖结构清晰度、伪影抑制、整体图像质量进行评估,比较不同图像的图像质量评分差异。结果 60 keV、120 keV、120 kV-like、60 keV+120 keV、120 kV-like+keV图像的AI值分别为(33.51±6.87)、(17.42±2.90)、(26.43±4.71)、(24.12±3.44)、(21.50±3.13),比较之下 60 keV＞120 kV-like＞120 kV-like+keV＞120 keV、60 keV+120 keV,差异有统计学意义(P<0.05)。120 keV及60 keV+120 keV图像的解剖结构清晰度评分显著高于60 keV、120 kV-like、120 kV-like+keV图像,P<0.05;60 keV+120 keV图像的伪影抑制、整体图像质量评分显著高于60 keV、120 keV、120 kV-like、120 kV-like+keV图像,均有P<0.05。结论肝硬化门静脉高压患者在TIPS术后行能谱CT单能量成像检查时以MAR对图像进行处理能够消除术后伪影,其中60 keV+120 keV消除图像伪影的同时还能清晰地对血管情况进行显示。

关键词: 肝硬化门静脉高压, 经颈静脉肝内门体分流术, CT, 金属伪影削减算法, 图像质量

Abstract: Objective To explore the application value of single energy imaging of energy spectrum computed tomography (CT) and metal artifact reduction algorithm (MAR) in the angiography of patients with liver cirrhotic portal hypertension after transjugular intrahepatic portoystemic stent shunt (TIPSS) treatment.Methods A total of 127 patients with liver cirrhotic portal hypertension who were admitted to affiliated hospital of Nantong University from May 2018 to May 2019 were selected. All the patients received TIPSS after admission and underwent single-energy imaging of energy spectrum CT examination at one month after the treatment. The images were processed by MAR method. The artifact index (AI) of 60keV, 120keV, 120kV-like, 60keV+120keV, 120kV-like +keV images were calculated, and the images were then reviewed by two experienced radiologists. The anatomical structure clarity, artifact suppression, and overall image quality of the images were evaluated by 5 grade scoring method, and the differences in image quality scores of different images were compared. Results The AI values of the images of 0keV, 120keV, 120kV-like, 60keV+120keV and 120kV-like +keV were (33.51±6.87), (17.42±2.90), (26.43±4.71), (24.12±3.44) and (21.50±3.13), respectively, and the differences were statistically significant (P<0.05).The anatomical clarity scores of 120keV and 60keV+120keV images were significantly higher than those of 60keV, 120kV-like and 120kV-like +keV images (P<0.05). Artifact inhibition and overall image quality scores of 60keV+120keV images were significantly higher than those of 60keV, 120keV, 120kV-like and 120kV-like +keV images, all with P<0.05.Conclusion In patients with portal hypertension due to cirrhosis, MAR image processing can eliminate postoperative artifacts when performing single-energy imaging of energy spectrum CT examination after TIPSS treatment, in which 60keV+120keV can eliminate image artifacts while clearly show the vascular condition.

Key words: Liver cirrhotic portal hypertension, Transjugular intrahepatic portosystemic stent shunt, Computed tomography, Metal artifact reduction algorithm, Image quality

单勤星, 张晓东, 王鑫. 能谱CT单能量成像及金属伪影削减算法在肝硬化门静脉高压TIPS术后血管成像的应用[J]. 肝脏, 2021, 26(5): 502-504.

SHAN Qin-xing, ZHANG Xiao-dong, WANG Xi. The application single energy imaging of energy spectrum computed tomography and metal artifact reduction algorithm in the angiography of patients with liver cirrhotic portal hypertension after transjugular intrahepatic portosystemic stent shunt treatment[J]. Chinese Hepatolgy, 2021, 26(5): 502-504.

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