320排CT单能量去金属伪影技术用于内脏动脉瘤弹簧圈栓塞术后随访的应用研究  

Clinical value of single energy metal artifact reduction technique of 320-row CT in the follow-up of visceral arterial aneurysms after coil embolization

作　　者：侯凯 吕鹏 唐启瑛 陆秀良 顾君英 曾蒙苏 HOU Kai;LV Peng;TANG Qi-ying(Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai Institute of Medical Imaging,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放射科/上海市影像医学研究所/复旦大学上海医学院影像学系,上海200032

出　　处：《放射学实践》2018年第4期423-427,共5页Radiologic Practice

摘　　要：目的:探讨320排CT迭代算法联合单能量射线去金属伪影技术(SEMAR)在内脏动脉瘤弹簧圈栓塞术后CT随访中的临床应用价值。方法:回顾性分析24例行内脏动脉瘤(脾动脉22例,肝动脉2例)弹簧圈栓塞术患者的CTA图像,对扫描原始数据分别采用单纯迭代重建算法和迭代重建算法联合SEMAR技术进行图像重建,对2组图像上瘤体内对比剂分布和血栓形成情况、动脉瘤体的大小、载瘤动脉和出瘤动脉的显示情况和邻近正常器官的血供情况进行评估和比较,主观评价采用4级评分法。结果:瘤体内血栓形成情况、载瘤动脉和出瘤动脉的显示情况及正常器官血供情况这四项的主观评分,SEMAR组均高于未采用SEMAR组,分别为(3.3±0.7)和(1.3±0.5)分(Z=-4.52,P<0.01)、(3.4±0.7)和(1.3±0.5)分(Z=-4.38,P<0.01)、(3.4±0.8)和(1.4±0.5)分(Z=-4.37,P<0.01)、以及(3.3±0.7)和(1.5±0.5)分(Z=-4.46,P<0.01)。4例患者因为严重伪影无法评价瘤体内径,余20例患者的瘤体内径在采用和未采用SEMAR组分别为(25.4±9.3)和(28.2±9.5)mm,组间差异有统计学意义(Z=-3.36,P<0.01)。结论:SEMAR技术可以明显减轻CTA图像上的金属伪影,有助于准确评估内脏动脉瘤腔内栓塞术的效果,在术后随访中具有较高的临床应用价值。Objective:To investigate the clinical value of single energy metal artifact reduction(SEMAR)technique combined with adaptive iterative reconstruction algorithm of 320-row CT in the follow-up of visceral arterial aneurysms after coil embolization.Methods:The CTA images of 24 patients with visceral arterial aneurysms after coil embolization were retrospectively analyzed.Among them,22 were splenic artery aneurysms,2 were hepatic artery aneurysms.All of the CTA data were reconstructed using only iterative reconstruction technique(group A)or iterative reconstruction combined with SEMAR technique(group B).The visualization of contrast media and thrombus in the aneurysms,the diameters of the aneurysms,the proximal and distal arteries of the aneurysms and the enhancements of target organs were analyzed and compared between the two techniques.Results:The scores of visualization of contrast media and thrombus in the aneurysms,the proximal and distal arte-ries of the aneurysms and enhancements of target organs in group B were higher than those in group A(3.3±0.7 vs 1.3±0.5,Z=-4.52,P<0.01;3.4±0.7 vs 1.3±0.5,Z=-4.38,P<0.01;3.4±0.8 vs 1.4±0.5,Z=-4.37,P<0.01;and 3.3±0.7 vs 1.5±0.5,Z=-4.46,P<0.01;respectively).The diameters of the aneurysms could not be calculated in 4 patients because of severe metal artifacts;in the remaining 20 patients,the diameter of aneurysms in group B was less than that in group A[(25.4±9.3)mm vs(28.2±9.5)mm,Z=-3.36,P<0.01].Conclusion:SEMAR technique can significantly reduce the metal artifacts and accurately assess the effect of the coil embolization of visceral arterial aneurysms,it has great application value in the follow-up.

关 键 词：CT血管成像 内脏动脉瘤 弹簧圈栓塞术 金属伪影 单能量射线去金属伪影技术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R814.43[医药卫生—放射医学]