双低条件下结合最适迭代权重在冠状动脉3D打印技术中应用  

Coronary artery 3D printing technology by using low dose of radiation and contrast agent combined with optimizing adaptive statistical iterative reconstruction technique

作　　者：李冠[1] 邹明宇[1] 杨本强[1] 张立波[1] 王金宝[1] 曹志强[2] 曹东兵 

机构地区：[1]沈阳军区总医院放射诊断科,辽宁沈阳110016 [2]沈阳军区总医院全军重症(战)创伤救治中心实验室,辽宁沈阳110016

出　　处：《临床军医杂志》2017年第6期632-635,共4页Clinical Journal of Medical Officers

基　　金：总后卫生部重大项目新上项目(AMS14L008)

摘　　要：目的比较不同权重自适应统计迭代重建(ASIR)技术在低浓度对比剂及低辐射剂量条件下行冠状动脉3D打印的可行性。方法选择2016年3—12月沈阳军区总医院收治的疑诊为冠状动脉心脏病并行冠状动脉CT成像(CCTA)检查的患者20例为研究对象。体质量指数(BMI)20~25 kg/m2,在双低条件下(100 k Vp及270 mg I/ml碘克沙醇对比剂)行前瞻性心电门控技术CCTA扫描,扫描完成后对图像进行滤波反投影法(FBP)及不同权重ASIR重建(20%、40%、60%、80%、100%),并将数据传至3D打印机,行冠状动脉3D建模打印,对3D打印产物进行主客观评价。结果相对于FBP重建算法,20%、40%、60%、80%、100%ASIR图像噪声分别降低9%、21%、30%、45%、52%(P<0.05),信号噪声比(SNR)、对比噪声比(CNR)分别提高约6%、17%、38%、56%、72%及12%、22%、42%、56%、66%(P<0.05)。不同权重ASIR重建图像CT值比较,差异无统计学意义(P>0.05)。行FBP,20%、40%、60%、80%、100%ASIR的3D打印产物主观评分分别为1.6、2.0、4.0、4.1、2.1、1.3分,组间比较,差异有统计学意义(P<0.05)。权重设置在40%、60%ASIR的3D打印产物质量具有最高主观评分,打印冠状动脉的质量最好。结论在双低条件下及ASIR重建技术行冠脉3D打印,相对于FBP重建算法,不同权重ASIR图像在40%、60%时,3D打印产物的质量具有最高主观评分,图像质量最好,同时可大幅度降低患者所受辐射剂量。Objective To compare the feasibility of using different ASIR reconstruction technique combine low close and low contrast agent apply coronary artery 3D printing. Methods A retrospective study was performed on 20 patients whose BMI from 20 to 25 kg/m2 with suspected coronary disease underwent coronary artery 3D printing from March to December 2016. Coronary artery CTA scanning parameters（ 100 kVp, contrast media：Visopaque 270 mgI/ml）and group information results were as the following：raw data reconstructed with different percentage of ASIR（0% ,20% ,40% ,60% ,80% and 100% ） ,then transmitted data to 3D printer under- went coronary artery 3D printing. The 3D printing products of different weight conditions underwent subjective and objective evaluation was performed. Results In comparison with FBP（0% ASIR） ,the use of 20% ,40% ,60% ,80% and 100% ASIR resulted in re- duced image noise between groups 9% ,21% ,30% ,45% and 52%, respectively（P 〈 0. 05）. ASIR also increased SNR and CNR be- tween groups 6%, 17% ,38% ,56% ,72% and 12% ,22% ,42% ,56% ,66%, respectively （P 〈 0.05 ）. There was no significant differ- ence in different weight ASIR reconstruction of CT DICOM data CT between groups（ P 〉 0.05 ）. To perform FBP,20% ,40% ,60% , 80% and 100% ASIR in the subjective scores 1.6,2. 0,4. 0,4. 1,2. 1 and 1.3 ,respectively（ P 〈 0. 05 ）. Reconstruction using 40% and 60% ASIR 3D printing product quality had the highest the subjective scores, display the best quality for coronary artery 3 D print- ing. Conclusion Under the condition of double low and ASIR reconstruction technique to perform 3 D printing, compared with FBP re- construction, reconstruction using 40% and 60% ASIR has the highest subjective scores of imaging quality in coronary artery 3D print- ing, and apparently reduce the radiation dose to patients.

关 键 词：3D打印技术 辐射剂量 冠状动脉 自适应统计迭代重建 

分 类 号：R541.4[医药卫生—心血管疾病]