CT理论与应用研究2026，Vol.35Issue(2)：239-248,10.DOI:10.15953/j.ctta.2025.185
肺动脉CTA虚拟单能成像赋能放射科技师:基于血栓显示优选能级提升肺动脉栓塞预警信心的研究
Virtual Monoenergetic Imaging of Pulmonary CT Angiography Empowers Technologists:Improvement of Pulmonary Embolism Alerting by Energy Level Optimization Based on Thrombi Presentation
摘要
Abstract
Objective:To optimize the virtual monoenergetic imaging(VMI)energy level for pulmonary computed tomography(CT)angiography(PCTA)based on image quality and thrombus visualization and evaluate its impact on the confidence of radiological technologists in detecting pulmonary embolism(PE).Methods:Patients who underwent PCTA because of clinical suspicion of PE at our hospital between February 2025 and March 2025 were prospectively screened.All examinations were performed using dual-source dual-energy CT,and the images were reconstructed into 120 kVp equivalent polyenergetic imaging(PEI)and VM images at energy levels of 70,60,50,and 40 keV.One radiological technologist conducted objective measurements to assess the ascending aorta,main pulmonary artery,left pulmonary artery branch,right pulmonary artery branch,right lower lobe pulmonary artery branch,left lower lobe pulmonary artery branch,liver parenchyma,and erector spinae muscle to obtain CT values(Hounsfield units[HU])and their standard deviations(SD)to calculate the signal-to-noise ratio(SNR).The contrast-to-noise ratio(CNR)was calculated using the SD value of the erector spinae muscle as the background noise.Two radiological technologists evaluated the images of 23 patients with thrombi using a 5-point scale to assess their confidence in alerting them to PE.A score of 5 denoted a high certainty of thrombus presence,necessitating immediate notification to the diagnostic physician for review and issuance of a critical value,whereas a score of 1 denoted no thrombus detection,requiring no prior review by the diagnostic physician.Differences in objective and subjective assessments between the different image groups were compared.Results:The study included 98 patients,with a mean age of(72.06±13.41)years,comprising 47 male and 51 female patients;23 had thrombi and 75 did not.Objective measurements revealed that in the 40,50,and 60 keV VMI images,as the VMI energy level decreased,the corresponding CT values increased,providing improved tissue contrast.However,the SD values also increased,indicating higher noise levels.In the 40 and 50 keV VMI images,the CNR values for the vessels and thrombi were higher than those in the PEI images.Subjective assessment showed that the two technologists detected almost all thrombi(225/230,97.8%),but had greater confidence in alerting PE when observing 50 keV VMI images than when observing PEI images((4.41±0.88)vs.(4.72±0.58)).Conclusion:For the clinical task of detecting PE using PCTA,50 keV VMI images are preferred to enhance the confidence of radiological technologists in alerting patients with PE,facilitating timely physician review and issuance of critical values,with the potential to improve clinical diagnoses and the treatment process for patients.关键词
CT肺动脉造影/X线计算机体层摄影/虚拟单能量成像/图像质量Key words
pulmonary CT angiography/X-ray computed tomography/virtual monoenergetic imaging/image quality分类
医药卫生引用本文复制引用
陈黎伟,王思连,代顺,许芷菡,宋阳,褚敬申,张欢,姚伟武,钟京谕..肺动脉CTA虚拟单能成像赋能放射科技师:基于血栓显示优选能级提升肺动脉栓塞预警信心的研究[J].CT理论与应用研究,2026,35(2):239-248,10.基金项目
国家自然科学基金(基于CT增强影像组学联合代谢组学构建急性胰腺炎重症化智能早期预警模型研究(82302183) （基于CT增强影像组学联合代谢组学构建急性胰腺炎重症化智能早期预警模型研究(82302183）
基于注意力-可解释图文信息挖掘创建膝骨关节炎交互式诊断报告系统(82471935) （82471935）
厌氧消化链球菌重塑局部进展期直肠癌免疫微环境及MR预测模型研究(82271934)) （82271934）
上海市卫生健康委员会项目(骨病多模态报告和数据系统(Bone-RADS)规范精准风险评估并优化诊疗管理建议的临床研究(20244Y0214)) （骨病多模态报告和数据系统(Bone-RADS）
上海市长宁区科学技术委员会项目(基于肺动脉CT血管造影等多参数构建急性肺栓塞后血栓残留预测模型研究(CNKW2024Y07)). （基于肺动脉CT血管造影等多参数构建急性肺栓塞后血栓残留预测模型研究(CNKW2024Y07）
