Analysis of pelvic vas deferens and its adjacent structure display and influencing factors on multiple-phase CT fusion imaging
Wang Yu1, Wang Huanjun2, Peng Yang2, Fu Wenhao2, Guan Jian2
1Department of Radiology, the Affiliated Zhongshan Traditional Chinese Medicine Hospital of Guangzhou University of Chinese Medicine, Zhongshan 528400, China; 2Department of Radiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Abstract:Objective To explore the feasibility of multiple-phase CT (MSCT)volume-rendered reconstruction and image fusion for displaying pelvic vas deferens and its adjacent structure, and analyze the influencing factors of displaying pelvic vas deferens.Methods The prospective study was conducted. A total of 174 male patients aged from 20 to 50 years old underwent multiple-phase abdominopelvic CT scan from January 2018 to April 2018 in the Affiliated Zhongshan Traditional Chinese Medicine Hospital of Guangzhou University of Chinese Medicine were prospectively included. Volume-rendered reconstruction and image fusion were made in all patients: pelvic section of vas deferens based on nonenhanced phase, iliac artery and iliac vein based on venous phase, ureter and bladder on delayed phase. The fusion images were evaluated: bilateral pelvic vas deferens, ureter, iliac vessels were clearly displayed, and no adjacent organs interference were considered as qualified images. The rest were unqualified images. then factors influencing image display were analyzed, and statistical analysis was performed.Results Fusion images from 72/182 (41.4%) patients were considered as qualified, on which bilateral vas deferens were clearly displayed and clinical analysis could be made. Fusion images from the remaining 102 (58.6%) were excluded. Factors affecting image displaying included body mass index (BMI), accumulation of small bowel in pelvic, overfilling of adjacent organs (bladder and/or rectum) as well as patients' age. The BMI range of the qualified images was 17.19-31.49(24.49±2.93)kg/m2, and the BMI range of the unqualified images was 14.17-27.95(20.59±3.02)kg/m2, and the difference was statistically significant (t=8.493, P<0.01). BMI≥22.55 kg/m2 was considered as the cut-off value for qualified images, with a sensitivity and specificity of 77.8%, and 73.6%, respectively(ROC curve 0.821, P<0.01). Images showing small bowel accumulation were considered disqualified. Patients without bladder and/or rectum overfilling had a higher percentage of qualified images [84.6%(44/52)vs 56.0%(28/50)] and the statistical difference was significant (χ2=10.054, P<0.01). Patients were divided into 3 groups according to age, although the proportion of qualified images increased with aging:26.7% (8/30) of 20-30 years old, 39.6% (19/48) of 31-40 years old and 46.9% (45/96) of 41-50 years old, no statistical significance was found(χ2=3.936, P>0.05).Conclusions The influencing factors of image displaying include BMI, accumulation of small bowel in pelvic, overfilling of adjacent organs as well as patients' age. For patients with BMI of 22.55 kg/m2 or above, qualified images displaying pelvic vas deferens and adjacent structure by MSCT volume-rendered reconstruction and image fusion can be made through a proper preparation such as intestinal preparation and moderate bladder filling before CT scan.
王毓, 王焕军, 彭洋, 付文皓, 关键. 输精管盆腔段及其周围结构的多层螺旋CT多期图像融合显示及影响因素分析[J]. 中华解剖与临床杂志, 2019, 24(4): 370-374.
Wang Yu, Wang Huanjun, Peng Yang, Fu Wenhao, Guan Jian. Analysis of pelvic vas deferens and its adjacent structure display and influencing factors on multiple-phase CT fusion imaging. Chinese Journal of Anatomy and Clinics, 2019, 24(4): 370-374.
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