右江医学2025，Vol.53Issue(6)：535-542,8.DOI:10.3969/j.issn.1003-1383.2025.06.009
光谱CT联合低对比剂量个性化方案在下肢CTA中的应用研究
Application of spectral CT combined with a low-contrast dose personalized protocol in lower extremity CTA
摘要
Abstract
Objective To explore the feasibility of replacing the conventional dose protocol with a dual-layer detector spectral CT(DLCT)combined with a low-contrast dose personalized injection protocol in lower extremity CT angiography(CTA),and to evaluate its image quality.Methods A prospective,randomized,controlled design was employed in this study,enrolling 64 patients with clinically suspected lower extremity atherosclerosis from June 2023 to November 2024(2 patients were excluded,leaving a final sample of 62 patients).The participants were randomly divided into control group(n=30,using the conventional contrast dose combined with hybrid iterative reconstruction)and experimental group(n=30,using an individualized low-dose protocol based on body weight combined with hybrid iterative reconstruction and 40-120 keV virtual monochromatic imaging[VMI]).Image analysis was performed by an experienced technician at a standardized workstation.Region of interest(ROI)was drawn in the lumen of the bilateral superficial femoral arteries(SFA),popliteal arteries(PA),anterior tibial arteries(ATA),and dorsalis pedis arteries(DPA),as well as in the adjacent muscle tissues.CT values and noise levels were measured quantitatively,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.Independent-samples t-tests were used to compare the objective parameters between the two groups,and two senior physicians were blinded to subjectively evaluate the images by a 5-point scale(vascular display clari-ty,degree of artifacts,and diagnostic confidence).In addition,Wilcoxon signed-rank test was used for statistical analysis of paired samples.Results At all anatomical levels,the CT values,SNR,and CNR of the experimental group's VMI at 40 keV and 50 keV were higher than those of the control group,and difference was statistically significant(P<0.05).Subjec-tive evaluation showed that the scores for the SFA segment at 40 keV and 50 keV in the experimental group were higher,and difference was statistically significant(all P<0.05).There were no statistically significant differences in the scores for the other segments of the vessels(all P>0.05).Conclusion DLCT combined with a low-contrast-dose protocol individualized by body weight can not only achieve a reduction in contrast agent dosage but also obtain vascular imaging quality comparable to that of conventional doses when using VMI at 40-50 keV,which can provide a new technical pathway for optimizing low-er extremity arterial CTA examination protocols.关键词
双层探测器光谱CT/低对比剂量/常规对比剂量/虚拟单能级成像/下肢CTAKey words
dual-layer detector spectral CT(DLCT)/low-contrast dose/conventional contrast dose/virtual monoener-getic imaging(VMI)/lower extremity CTA分类
医药卫生引用本文复制引用
李鑫,黄光仪,杨鹏,杨旭日,伍玲,陆小玲..光谱CT联合低对比剂量个性化方案在下肢CTA中的应用研究[J].右江医学,2025,53(6):535-542,8.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201422) （Z20201422）
