CT理论与应用研究2026，Vol.35Issue(2)：222-230,9.DOI:10.15953/j.ctta.2025.106
能谱CT最佳虚拟单能量图像减影法在头颈CTA中的应用价值研究
Evaluation of Optimal Virtual Single-energy Image Subtraction Method for Energy-spectrum CT in Head and Neck CTA
摘要
Abstract
Objective:In this study,energy spectrum CT optimal virtual single energy image(VMI)with virtual flat scan(VUE)phase subtraction was compared with the matched mask bone elimination(MMBE)method in the subtraction of head and neck CT angiography(CTA).Methods:This retrospective study comprised 80 patients who underwent head and neck CTA between January 2024 and February 2025 at our institution.Reconstruction of image data was performed at 10 keV intervals,with eleven groups of VMI data from 40～140 keV ultimately reconstructed.The CT values and standard deviations of the common carotid artery(CCA),internal carotid artery(ICA),middle cerebral artery(MCA),and anterior cerebral artery(ACA)were measured,and the signal-to-noise ratio(SNR)and the contrast-to-noise ratio(CNR)were calculated.Then,subjective scoring of the 11 groups of VMI images was performed by two senior attending physicians.The outcomes of the objective evaluation indexes and subjective scoring were statistically analyzed to identify the best VMI images.The subtraction images obtained from the optimal VMI subtraction VUE were compared with the MMBE subtraction images,including arterial and venous system vascularization,debulking,overall image quality grade,and effective radiation dose.Results:The differences in the SNR and CNR of CCA,ICA,MCA,and ACA between the VMIs of each energy level were statistically significant,with the SNR and CNR of 60 keV images found to be higher than those of other VMI images.The radiologists showed good agreement on their subjective evaluations of VMI image quality at each energy level(Kappa>0.61).The differences in subjective scores between the VMI at each energy level were statistically significant,with the 60 keV images showing the highest subjective scores.The subtracted images of ICA intracranial segment,vertebral artery(VA)intracranial segment,and intracranial artery after subtraction of the 60 keV images and VNC were significantly better than those of the MMBE method.The debulking effect of its subtraction was also significantly better than that of the MMBE method.The percentage of the overall image quality of Grade I was 88.75%(71/80),significantly higher than that of the MMBE method(77.50%,62/80).Its average effective radiation dose was(0.96±0.02)mSv,approximately 44.24%lower than that of the MMBE method-a difference that was statistically significant.Conclusion:We identified 60 keV as the best virtual single energy for displaying head and neck CTA.Its subtracted image was better in terms of head and neck arterial vascular display,debridement effect,and overall image quality grade.This highlights its potential as an alternative to the traditional matched-mask debridement method.By omitting the true flat scan,the radiation dose can be significantly reduced,providing a novel mechanism for the optimization of head and neck CTA.关键词
虚拟单能量成像/单能量减影法/头颈CT血管成像/匹配蒙片去骨法/减影效果Key words
virtual monoenergetic image/single energy subtraction method/head and neck CT angiography/matched mask bone elimination/subtraction image effect分类
医药卫生引用本文复制引用
祁冬,李娟,司峥,黄锐,刘学学..能谱CT最佳虚拟单能量图像减影法在头颈CTA中的应用价值研究[J].CT理论与应用研究,2026,35(2):222-230,9.基金项目
数字医学与智慧健康安徽省重点实验室(蚌埠医科大学)开放课题(AHCM2024W010) （蚌埠医科大学）
蚌埠市科技创新指导类项目(20220104). （20220104）
