一键去骨法与减影法在头颅CTA血管重建中的对照研究  

Control Study of One-click Bone Removal and Subtraction in the Reconstruction of Cerebral CTA

作　　者：陈荣云 彭伟 王苇[1] 徐文娟 赵义[1] 李琛玮 CHEN Rong-yun;PENG Wei;WANG Wei;XU Wen-juan;ZHAO Yi;LI Chen-wei(Medical Imeging Center,The Affiliated Hospital of Yangzhou University;Department of Radiology,Yizheng People Hospital;Shanghai United Imaging Healthcare Co.Ltd)

机构地区：[1]扬州大学附属医院医学影像中心 [2]仪征市人民医院放射科 [3]上海联影医疗科技有限公司

出　　处：《中国医学计算机成像杂志》2020年第2期170-175,共6页Chinese Computed Medical Imaging

基　　金：扬州市"十三五"科教强卫工程重点学科资助项目(No.ZDXK20186)。

摘　　要：目的:比较一键去骨法与减影法在头颅CTA血管重建中图像质量及对血管病变检出的差异,探讨一键去骨法的应用价值。方法:对247例患者分别进行一键去骨法和减影法头颅CTA重建,对两种去骨法CTA所得颈内动脉(七段),大脑前、中、后动脉(分别为四段),椎动脉(四段),前后交通动脉和基底动脉血管图像质量按照5个等级标准进行评分,同时分别记录两组图像诊断病变血管数目分布差异。应用秩和检验比较两组血管图像质量差异,配对卡方检验比较两者诊断病变血管能力差异。结果:247例病例共10868段脑动脉。两种方法总体图像质量评分无统计学差异(P=0.405),一键去骨法血管质量评分均值为4.49±1.098,减影法血管质量评分均值为4.50±1.065,双侧椎动脉V4段图像质量减影法优于一键去骨法(左侧V4:P=0.026,右侧V4:P=0.017)。双侧颈内动脉C2段图像质量一键去骨法优于减影法(左侧C2:P=0.039;右侧C2:P=0.028)。其他分段血管图像质量评分两者无统计学差异。在血管狭窄、闭塞及动脉瘤检出方面两者无统计学差异。在血管钙化及血管病变术后金属夹、支架显示一键去骨法优于减影法(P均为0.000)。结论:一键去骨法对于血管病变显示和图像质量均不劣于减影法,在显示血管钙化和金属夹、支架方面有一定优势,值得应用和推广。Purpose:To compare the differences in image quality and display of vascular lesions in reconstruction of cerebral CTA between one-click bone removal CTA(as oCTA)and subtraction CTA(as sCTA)and to investigate the application value of oCTA.Methods:Two hundred and forty-seven patients who had undergone with cerebral CTA were enrolled.The original CTA images were reconstructed with oCTA and sCTA respectively and the image quality of carotid arteries(7 segments),cerebral arteries(anterior,middle and posterior cach with 4 segments),vertebral arteries(4 segment),anterior and posterior communication arteries and basilar arteries were graded into 5 levels(grades=excellent,gradel=worst).In the meantime,the number and the distribution of the lesion vessels were also recorded.The difference in image quality was analyzed by rank test,while the vessel diagnosis capability by chi-square test.Results:There were totally 10868 cerebral arteries in the 247 cases.There was no statistical difference in the overall image quality score between the two methods(P=0.405).The average grade of oCTA was 4.49±1.098 and sCTA was 4.50±1.065.The image quality of the fourth segment of the bilateral vertebral arteries on sCTA was superior to that on oCTA(for left V4 arteries:P-0.026;and the right:P=0.017).The image quality of the second segment of the bilateral carotid arteries on oCTA was superior to that on sCTA(for left C2 arteries:P=0.039;and the right:P-0.028).There was no statistical difference between the image quality scores of other segments.There was no statistical difference between the detection of vascular stenosis,occlusion and aneurysm.On the display of vessel wall calcification and metal clip or stent,oCTA was better than sCTA(P=0.000).Conclusion:oCTA is not worse than sCTA in displaying lesion arteries as well as on the image quality.In revealing of vessel wall calcification and metal clip or stent,oCTA shows more advantage.Thus it is worth of application and promotion。

关 键 词：一键去骨法 减影法 CTA 图像质量 

分 类 号：R445.6[医药卫生—影像医学与核医学]