全模型迭代重建技术(FIRST)在改善冠状动脉支架成像中的价值  

Effect of the Forward Projected Model-Based Iterative Reconstruction Solution(FIRST)on Improving Image Quality of Coronary Artery Stent in Cardiac CT Angiography

作　　者：曹立坤 王怡宁 易妍 王沄 马壮飞 闫静 付海鸿 金征宇[1] CAO Likun;WANG Yining;YI Yan;WANG Yun;MA Zhuangfei;YAN Jing;FU Haihong;JIN Zhengyu(Department of Radiology,Peking Union Medical College Hospital,Beijing 100730,China;Canon Medical System(China)Co.,Ltd.,Beijing 100015,China)

机构地区：[1]北京中国医学科学院北京协和医院放射科,北京100730 [2]佳能医疗系统(中国)有限公司,北京100015

出　　处：《中国医疗设备》2021年第11期71-75,共5页China Medical Devices

摘　　要：目的探讨全模型迭代算法(Forward Projected Model-Based Iterative Reconstruction Solution,FIRST)在改善冠状动脉CT血管造影(CT Angiography,CTA)支架成像质量中的价值。方法回顾性纳入于我院接受冠脉CTA检查的44例冠脉支架(59枚)置入术后患者。使用FIRST-Cardiac(FIRST-C),FIRST-Cardiac Sharp(FIRST-CS),混合迭代重建法(Adaptive Iterative Dose Reduction 3D,AIDR-3D)和滤波反投影法(Filtered Back Projection,FBP)四种算法重建图像。对所有图像行包括管腔信噪比(Signal-to-Noise Ratio,SNR)、对比噪声比(Contrast-to-Noise Ratio,CNR)、支架可见内径及支架内腔衰减率(Stent lumen Attenuation Increase Ratio,SAIR)等在内的客观评价,由2位医师采用5分值行双盲主观评分。比较四组图像间客观与主观评价的差异。结果图像质量客观分析显示,管腔SNR、CNR、支架可见内径和SAIR值在四组间差异均有统计学意义(P<0.001)。FIRST-C的管腔SNR、CNR显著优于其他三组(P<0.05);FIRST-CS组支架可见内径最大(1.96±0.42)mm,管腔衰减率最低0.32±0.27,优于其他三组。主观评分中,FIRST-C与FIRST-CS图像均满足诊断要求,FIRST-CS组评分最高,依次高于FIRST-C、AIDR-3D组和FBP组。结论与AIDR-3D、FBP相比,FIRST有助于改善冠脉支架图像质量,FIRST-C能有效提高管腔SNR,FIRST-CS在支架内腔可视化中更具优势,能为临床提供高质量图像。Objective To explore the potential of forward projected model-based iterative reconstruction solution (FIRST) in improving the image quality of coronary artery stents in CT angiography (CTA). Methods A total of 44 patients with 59 coronary stents who underwent coronary CTA in our hospital were included retrospectively. The images were reconstructed with FIRST-Cardiac (FIRST-C), FIRST-Cardiac Sharp (FIRST-CS), adaptive iterative dose reduction 3D (AIDR-3D) standard and filtered back projection (FBP) respectively. All images were evaluated objectively, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) of stent lumen, visible inner diameter of stent, and the stent lumen attenuation increase ratio (SAIR). Two radiologists visually evaluated the image quality of the stents and performed double-blind subjective scoring with 5-point scale (1=poor, 5=excellent). The difference between objective and subjective evaluation was compared between the four groups. Results Objective analysis of image quality showed that there were significant differences in SNR, CNR, visible inner diameter of stent and SAIR among these four groups (P<0.001). The SNR and CNR of FIRST-C group were significantly better than the other three groups (P<0.05);the visible inner diameter of stent in the FIRST-CS group was the largest (1.96±0.42) mm, and the SAIR was the lowest 0.32±0.27, which was better than the other three groups. Among the subjective scores, FIRST-C and FIRST-CS images met the diagnostic requirements. The score of FIRST-CS group was the highest, which was sequentially higher than that of FIRST-C, AIDR-3D group and FBP group. Conclusion Compared with AIDR-3D and FBP, FIRST helps to improve the image quality of coronary stent. FIRST-C can effectively improve the SNR. FIRST-CS has more advantages in stent lumen visualization and can provide high-quality images for clinic.

关 键 词：冠状动脉CT血管成像 冠脉支架 全模型迭代算法 图像质量 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]