| Purpose:To investigate the application value of energy spectrum CT aortic angiography combined with blood(iodide)based image in the diagnosis of aortic intermural hematoma.Methods:A total of 36 groups of image data were collected from 23 patients who were admitted to China-Japan Friendship Hospital of Jilin University from August 2020 to February 2021 and who were clinically highly suspected or had been diagnosed with IMH.The scanned images are transferred to the AW4.7 workstation provided by the energy spectrum CT system,and the images are processed by the GSI Viewer software to obtain the automatically generated virtual plain scan images and the post-processed blood(iodine)based material images.First,the images were divided into simple aortic energy spectrum CTA(control group)and aortic energy spectrum CTA combined with blood(iodine)based substances(study group).The images of the control group were randomly and anonymously distributed to two radiologists with 5 years of working experience.The two doctors respectively diagnosed the images of the control group and recorded the diagnosis results.Later,images of the study group were sent to both doctors at the same time for diagnosis and the results were recorded.When the two doctors do not agree on the diagnosis results of the same group of images,they reach a consensus after discussion and give the diagnosis results.Secondly,pure energy spectrum CTA images,virtual plain scan images and blood(iodine)based images were randomly distributed to two radiologists with three years of working experience.The two doctors rated the details of the three groups of images subjectively,and the two doctors were unaware of the type of images they read.The evaluation included the maximum thickness of aortic wall,the number of calcification on aortic wall,the display of aortic intima and image artifacts.Finally,the contrast noise ratio(CNR)of blood(iodine)histogram and virtual plain scan images were measured and calculated.SPSS 25 statistical software was used to perform statistical analysis on the above data,so as to evaluate the advantages of energy spectrum CTA combined with blood iodine-based images in the diagnosis of aortic intermural hematoma.Results:The diagnostic rate of images in the study group was higher than that in the control group.The subjective independent scores of blood iodide,control and virtual plain scan images were(2.28±0.78,1.89±0.75,1.39 ± 0.72),respectively,and the difference was statistically significant(P<0.05),the results showed that the blood iodogram was better than the simple application of energy spectrum CTA and virtual plain scan images for the display of details of aortic lesions.From ascending aorta to descending aorta at iliac vessel bifurcation,the number of calcifications detected by pure energy spectrum CTA and virtual plain scan images were lower than those detected by blood(iodide)based images(60.83 ± 29.57,62.22 ± 29.93,65.75 ± 30.79,P<0.05).The results of quantitative analysis of virtual plain scan and blood(iodine)based images showed that the CNR value between the vessel wall and the active vessel lumen was slightly higher than that of VNC images(1.62±0.74,1.04±0.48,P<0.05);However,there was no significant difference in the CNR values between the vascular wall and the periperitoneal(or periaortic)fat in the normal aortic segment and the aortic segment with IMH between the two groups,P>0.05.Conclusion:The blood(iodine)base map can increase the detection of small calcification and obtain better image quality,and compared with CTA alone,energy spectrum CTA combined with postprocessed blood(iodine)histogram can improve the diagnostic rate of aortic intermural hematoma. |
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