单能量技术结合ASIR-V算法在疑似新型冠状病毒肺炎患者行低剂量CT扫描中的应用价值  

Value of single energy technique combined with ASIR-V algorithm in low dose CT scanning of patients with suspected COVID-19

作　　者：祁冬[1] 姜研[1] 姚传顺[1] 何兴义 田欧[1] 陈冠亚 QI Dong;JIANG Yan;YAO Chuanshun;HE Xingyi;TIAN Ou;CHEN Guanya(Department of Medical Imaging,First People’s Hospital of Bengbu,Bengbu 233000,China)

机构地区：[1]安徽省蚌埠市第一人民医院医学影像科,安徽蚌埠233000

出　　处：《中国中西医结合影像学杂志》2020年第5期453-457,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的 :探讨单能量技术结合多模型迭代重建(ASIR-V)算法在疑似新型冠状病毒肺炎(简称新冠肺炎)患者行低剂量CT扫描中的应用价值。方法:前瞻性分析80例疑似新冠肺炎患者,随机分为低剂量组和常规剂量组各40例,低剂量组采用能谱扫描模式和ASIR-V算法,常规剂量组采用传统扫描模式和滤波反投影算法(FBP)。对比2组的图像质量、CT剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(ED)。以新型冠状病毒核酸检测作为诊断金标准,比较2种扫描模式的诊断效能。结果:2组图像质量主观评分差异无统计学意义(P> 0.05),2名医师对图像质量主观评价的一致性较好(K=0.81,P<0.05)。2组在胸廓入口处胸锁乳突肌、T6水平胸主动脉及肺底竖脊肌3处的SNR差异均无统计学意义(均P> 0.05)。低剂量组CTDIvol、DLP及ED均明显低于常规剂量组,差异均有统计学意义(均P<0.05)。低剂量组诊断疑似新冠肺炎患者的敏感度、特异度、阳性预测值、阴性预测值及诊断符合率分别为84.38%、87.50%、96.43%、58.33%、85.00%,常规剂量组分别为90.63%、75.00%、93.55%、66.67%、87.50%,差异均无统计学意义(均P> 0.05)。结论:单能量技术(110 keV)结合80%ASIR-V算法低剂量CT扫描能够在保证图像质量的前提下降低辐射剂量,对新冠肺炎的筛查、辅助诊断及预后随访具有重要的临床应用价值。Objective:To explore the value of single energy technique combined with adaptive statistical iterative reconstruction and Veo(ASIR-V)algorithm for low dose CT scanning in patients with suspected COVID-19.Methods:A total of 80 patients with suspected COVID-19 were randomly divided into the low dose group and the conventional dose group according to CT scanning protocol.The low dose group adopted energy spectrum scanning mode and ASIR-V algorithm,and the conventional dose group adopted traditional scanning mode and filtered back projection(FBP)algorithm.The differences of volume CT dose index(CTDIvol),dose lenth product(DLP),effective dose(ED),image quality and diagnostic efficiency in the two groups were compared.Results:There was no significant difference in subjective score of image quality of the two groups(P>0.05),and the consistency among two physicians was good(K=0.81,P<0.05).There were no significant differences between the two groups in SNR of the sternocleidomastoid at the entrance of the chest,the thoracic aorta at the sixth dorsal vertebra level and the vertical spinal muscle at the lung floor(all P>0.05).The CTDIvol,DLP and ED of the low dose group were significantly lower than those of the conventional dose group(all P<0.05).The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 84.38%,87.50%,96.43%,58.33%,85.00%in the low dose group,which had no significant differences with the conventional dose group of 90.63%,75.00%,93.55%,66.67%,87.50%,respectively(all P>0.05).Conclusions:Single energy technology(110 keV)combined with 80%ASIR-V algorithm for suspected COVID-19 patients with low dose CT scanning can significantly reduce the radiation dose under the premise of ensuring image quality,which has important clinical application value for screening,auxiliary diagnosis and prognosis follow-up of patients with COVID-19.

关 键 词：体层摄影术 X线计算机 多模型迭代重建算法 新型冠状病毒肺炎 辐射剂量 

分 类 号：R563.1[医药卫生—呼吸系统]