摘要目的:探讨双能CT迭代重建技术(SAFIRE)联合虚拟平扫(VNC)对肺癌的评估价值。方法:前瞻性纳入2022年10月至2023年10月河南省人民医院经病理诊断明确为肺癌的58例患者作为研究对象。患者入院后均接受双能CT常规平扫(TNC)，采用SAFIRE技术重建动脉期、门脉期图像，后得到SAFIRE动脉期VNC(VNCa)图像、静脉期VNC(VNCv)图像。测量患者TNC与VNC图像中各部位CT值及信号噪声比(SNR)值，记录CT剂量指数(CTDIvol)、剂量长度乘积(DLP)，计算有效剂量(ED)，对图像进行主观评分。结果:TNC与VNCa、VNCv图像主动脉、肺动脉、竖脊肌各部位CT值及SNR值比较差异未见统计学意义( P>0.05)；TNC图像可诊断率与VNCa、VNCv图像可诊断率比较差异未见统计学意义( P>0.05)；TNC图像主观评分高于VNCa、VNCv( P<0.05)，而VNCa与VNCv图像主观评分比较差异未见统计学意义( P>0.05)；双期双能扫描CTDIvol、DLP、ED水平低于常规三期扫描( P<0.05)。 结论:双能CT SAFIRE技术联合VNC可提供较为准确的病灶部位CT值，图像质量良好，可满足临床诊断需求，且能降低辐射剂量。

abstractsObjective:To investigate the value of dual-energy CT sinogram affirmed iterative reconstruction (SAFIRE) combined with virtual non-contrast (VNC) in evaluation of lung cancer.Methods:A prospective study was conducted on 58 patients diagnosed with lung cancer by pathological examination in Henan Provincial People’s Hospital from October 2022 to October 2023. After admission, the patients underwent dual-energy CT true non-contrast (TNC) scan; the arterial and portal phase images were reconstructed using SAFIRE technology, resulting in the SAFIRE arterial phase VNC (VNCa) and venous phase VNC (VNCv) images. The CT values and signal-to-noise ratio (SNR) values of each part in the TNC and VNC images were measured. The CT dose index (CTDIvol) and dose length product (DLP) were recorded, moreover, the effective dose (ED) was calculated; after then, the images were subjectively scored.Results:There was no statistical significant difference in CT and SNR values of the aorta, pulmonary artery, and erector spinae muscle between TNC and VNCa, VNCv images ( P>0.05). The diagnostic rate of TNC images had no significant differences with the diagnostic rafe of VNCa and VNCv images ( P>0.05). The subjective score of TNC images was higher than that of VNCa and VNCv ( P<0.05). However, there was no statistical significant difference in subjective scores between VNCa and VNCv images ( P>0.05). The levels of CTDIvol, DLP, and ED in dual-phase dual-energy scanning were lower than those in conventional triple-phase scanning ( P<0.05). Conclusions:Dual-energy CT SAFIRE technology combined with VNC can provide more accurate CT values for lesion locations, with good image quality, which can meet clinical diagnostic reauirements and reduce radiation dose.