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目的 探讨基于双层探测器光谱CT的不同成像方案在民航飞行员微小肾结石鉴别中的图像质量、辐射剂量及诊断效能差异。方法 回顾性纳入2024年5月至2025年7月于民航总医院接受泌尿系压腹增强CT检查的120例肾结石（直径≤5 mm）民航飞行员，采用随机数字表法将其随机分为两组：对照组和光谱组，每组60例。光谱组重建40 keV与55ke V虚拟单能量图像，对照组重建传统图像。以输尿管电子纤维软镜检查为金标准，评价两组图像质量评分及结石检出率。结果 40 keV图像为最佳虚拟单能量图像。光谱组40 keV图像质量与对照组传统图像比较，差异无统计学意义（P>0.05）。对照组诊断肾结石的准确率、敏感度和特异度分别为93.22%、92.86%和94.12%；光谱组的准确率、敏感度和特异度分别为93.86%、94.12%和93.10%。结论 双层探测器光谱CT 40 keV虚拟单能量图像在保证图像质量的同时，约可降低30%辐射剂量与50%碘对比剂用量，在飞行员微小肾结石筛查中具有重要的临床价值。
Abstract：Objective To explore the differences in image quality, radiation dose and diagnostic efficacy of different imaging protocols based on dual-layer detector spectral CT in the differentiation of small kidney stones(diameter≤5 mm) in civil aviation pilots. Methods A total of 120 civil aviation pilots with kidney stones(diameter ≤ 5 mm) who underwent enhanced CT urography with abdominal compression in our hospital from May 2024 to July 2025 were retrospectively included. They were divided into the control group and the spectral group, with 60 cases in each group. The spectral group underwent reconstruction of 40 keV and 55 keV virtual monoenergetic images(VMI), while the control group underwent reconstruction of conventional images. Using ureteroscopic electronic flexible ureteroscopy as the gold standard, image quality scores and stone detection rates were evaluated for the two groups. Results The 40 keV images were consistently identified as the optimal VMI. There was no statistically significant difference in image quality between the 40 keV images in the spectral group and the conventional images in the control group(P>0.05). The accuracy, sensitivity, and specificity for the control group were 93.22%, 92.86%, and 94.12% respectively, while they were 93.86%, 94.12%, and 93.10% respectively for the spectral group. Conclusion The 40 keV VMIs of the dual-layer detector spectral CT can significantly reduce the radiation dose by approximately 30% and the amount of iodine contrast agent by 50% while ensuring image quality. It has significant clinical value for small kidney stones screening in pilots.
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基本信息:
DOI：10.16289/j.cnki.1002-0837.2026.01005
中图分类号:R856.5
引用信息:
[1]杨杉,朱海峰,王玉婕,等.双层探测器光谱CT不同成像方案对民航飞行员微小肾结石诊断价值的探讨[J].航天医学与医学工程,2026,37(01):24-29.DOI:10.16289/j.cnki.1002-0837.2026.01005.