【摘要】 目的 探讨双能量CT(DECT)80 kVp检出富血供肝细胞癌时，单位去脂体质量(LBW)的适宜碘剂量。方法 76例富血供肝细胞癌(HCC)患者行DECT增强扫描。在80 kVp肝动脉期图像中采用定性的肿瘤肝脏对比(QLTLC)和定量的肿瘤肝脏对比噪声比(QTTLCNR)评估肿瘤的醒目度。定性评估为“良好”组中QTTLCNR值的中位数和75%分位数分别作为强化效果满足准确诊断的最小和充分QTTLCNR。根据碘剂量(mg I/kg LBW)与QTTLCNR的关系估计合理的碘剂量。结果 QLTLC与QTTLCNR之间具有良好的相关性。在最小(3.43)和充分(4.04)的QTTLCNR基础上，动脉期图像合理的碘剂量为546～584 mg I/kg LBW。门静脉期图像中，肝脏强化达到50 HU的对比剂碘剂量为449 mg I/kg LBW。结论 DECT 80 kVp图像检出富血供HCC时，适宜的碘剂量可能为546～584 mg I/kg LBW。更多还原

【Abstract】 Objective To explore the optimal iodine dose per unit of lean body weight(LBW) for detecting hypervascular hepatocellular carcinoma(HCC) on 80 kVp of dual-energy CT(DECT). Methods 76 patients with hypervascular HCC were underwent liver contrast-enhanced DECT.The tumor conspicuity of hepatic arterial phase(HAP) images on 80 kVp dataset was assessed by qualitative tumor-to-liver contrast(QL-TLC) and quantitative tumor-to-liver contrast-to-noise ratio(QT-TLCNR).Minimal QT-TLCNR and sufficient QT-TLCNR that kept the contrast effect to be diagnosed accurately were defined as the median and 75% of QT-TLCNR assigned with “good”,respectively.The optimal iodine dose was estimated by the relationship between iodine dose(mgI/kg LBW) and QT-TLCNR.Results There was a good correlation between QL-TLC and QT-TLCNR.The optimal iodine dose in the HAP was considered to be in the range of 546-584 mgI/kg LBW,based on minimal(3.43) and sufficient QT-TLCNR(4.04). The iodine dose to achieve 50 HU hepatic enhancement was 449 mgI/kg LBW in the portal venous phase. Conclusion The optimal iodine dose required to detect hypervascular HCC on 80 kVp of DECT may be 546-584 mgI/kg LBW.更多还原