Stellar光子探测器薄层重建对冠脉支架CT成像效果的影响  

Computed tomography coronary stent imaging using Stellar photon detector:impact of thin slice reconstruction for stent evaluation

作　　者：金士琪 杨帆[1] 初金刚[1] 于扬 赵宇[1] 戴旭[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]西门子医疗CT事业部,沈阳110001

出　　处：《放射学实践》2016年第12期1177-1181,共5页Radiologic Practice

摘　　要：目的：评价Stellar光子探测器联合Safire迭代重建技术冠脉CTA中不同重建层厚对冠脉支架显示的影响,探讨改善CT冠脉支架成像效果的有效方法。方法：36例冠状动脉支架（81个）植入术后患者行双源CT（采用Stellar光子探测器）冠状动脉血管成像,使用Safire迭代重建技术、并分别采用3种层厚（0.50、0.60及0.75mm）进行图像重建获得3组图像。对图像质量进行主观和客观评价,并比较3组图像间的差异。结果：两位阅片者对三组图像质量主观评分的一致性均良好（Kappa=0.85~0.88）。三组间支架显示情况的评分差异有统计学意义（P=0.000）,以0.50mm组的评分最高[（94.130±0.558）分];图像噪声的主观评分中,随着重建层厚的增加,图像的噪声降低,三组间差异有统计学意义（P=0.000）,但0.50mm组与0.60mm组之间的差异无统计学意义（P〉0.05）。图像质量客观分析显示,支架内管腔噪声在3组间的差异无统计学意义（P〉0.05）。结论：Stellar光子探测器0.50mm层厚重建配合Safire迭代重建技术获取的冠脉支架CTA图像质量整体最佳,尤其对于直径〈3mm的冠脉支架,能为临床提供高质量的图像。Objective：To assess thin slice reconstruction for stent evaluation in CT coronary stent imaging using Stel lar photon detector and Safire iterative reconstruction technique,to explore the effective method for improving the quality of CT coronary stent imaging. Methods：36 patients with 81 coronary stents were examined using a dual source CT with circuit Stellar photon detector. Images were reconstructed at slice thickness of 0.75,0.60 and 0.50mm with IRIS and sharp kernel technique. Subjective and objective evaluation of image quality of the three groups were performed and compared by two experienced radiologists independently. Results：The subjective evaluation results of the three groups between the two radiologists showed good agreement （Kappa 0. 85-0.88）. Among the three groups,there were significant differences of image quality scores （P= 0. 000）, images of 0.50mm group was rated best for clearly showing the details of the stents and in-stent lumen with the highest score of 94. 130±0. 558. Subjective image noise assessment showed that with the increasing of slice thickness,the image noise decreased with significant difference among the three groups （P= 0. 000）, but the difference of image noise between 0.50mm-group and 0.60ram-group was not statistically significant （P〉0.05）. Objective evaluation of image quality showed that the noise of in-stent lumen among the three groups was not significant different （P〉0.05）. Conclusion： Stent visualization can be benefited from Stellar photon detector CTA using 0.5mm slice thickness for more accurate assessment of lumen narrowing and lower image noise,especially can afford high quality images for 〈3mm stent.

关 键 词：冠状动脉支架 光子探测器 体层摄影术 X线计算机 迭代重建技术 图像质量 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]