ADMIRE联合能谱纯化低剂量胸部CT平扫对冠状动脉钙化积分的影响  

Effect of ADMIRE combined with tin filtration low-dose chest CT scan on coronary artery calcium score

作　　者：刘瑛 陈学志 于皓 李清林 高晓玲 周连军 李文忠 丛培欣 LIU Ying;CHEN Xuezhi;YU Hao;LI Qinglin;GAO Xiaoling;ZHOU Lianjun;LI Wenzhong;CONG Peixin(CT Room,Ningcheng County Central Hospital,Ningcheng,Inner Mongolia 024200,China)

机构地区：[1]赤峰市宁城县中心医院CT室,内蒙古宁城024200

出　　处：《实用放射学杂志》2022年第10期1696-1700,共5页Journal of Practical Radiology

摘　　要：目的探讨双源CT高级模型迭代重建算法(ADMIRE)联合能谱纯化的低剂量胸部CT平扫在冠状动脉钙化积分(CACS)及危险度分层的影响及降低辐射剂量的价值。方法选取疑诊冠心病并有冠状动脉钙化患者进行前瞻性研究,患者均行常规剂量及低剂量CT(LDCT)扫描,常规剂量数据采用滤波反投影(FBP)重建,低剂量数据采用FBP,ADMIRE强度分别为1、3、5进行重建,分别计算Agatston积分、升主动脉CT值、标准差(SD)、信噪比(SNR)、对比噪声比(CNR)、辐射剂量,以常规FBP重建方法的CACS作为标准,分别比较LDCT不同重建组与常规FBP组之间的差异。结果LDCT组有效剂量(ED)为(0.056±0.017)mSv;常规FBP组ED为(0.685±0.455)mSv,2组差异有统计学意义(P<0.05);LDCT组升主动脉CT值低于常规FBP组,LDCT组中除ADMIRE 5升主动脉CT值SD低于常规FBP组外,其余各组均高于常规FBP组,LDCT各组中升主动脉CT值SD随着ADMIRE强度的增加逐渐降低且差异有统计学意义(P<0.05),常规FBP组SNR高于LDCT FBP组、LDCT ADMIRE 1组、LDCT ADMIRE 3组,与LDCT ADMIRE 5组差异无统计学意义;常规FBP组CNR低于LDCT组,LDCT组随着ADMIRE强度的增加逐渐升高且差异有统计学意义(P<0.05)。Agatston积分差异均有统计学意义(P<0.05),LDCT组均低于常规FBP组,LDCT组中以FBP组最大,ADMIRE 5组最小,受检者钙化风险分级在LDCT组发生不同数量降低一等级,尤以LDCT ADMIRE 5组为著。结论低剂量胸部CT检查明显降低辐射剂量,ADMIRE可以降低图像噪声,两者结合优化图像质量,降低钙化积分并造成风险分级的降低。Objective To investigate the effect of advanced modelled iterative reconstruction(ADMIRE)combined with tin filtration low-dose chest CT scan on coronary artery calcium score(CACS),risk stratification and reduction of radiation dose,Methods The patients with suspected coronary heart disease and coronary artery calcium were enrolled for the prospective study and then underwent conventional and low-dose CT(LDCT)scans.The CT data from conventional-dose scan were reconstructed by filtered back projection(FBP),while the data from low-dose scan were reconstructed by FBP combined with ADMIRE with the intensities of 1,3 and 5.The Agatston score,ascending aorta CT value,standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and radiation dose were calculated,respectively.The CACS based on the conventional FBP reconstruction was used as a standard,and the difference between the LDCT reconstruction group and the conventional FBP group were compared,respectively.Results The effective dose(ED)was(0.056±0.017)mSv in the LDCT group and(0.685±0.455)mSv in the conventional FBP group,exhibiting a statistically significant difference between the two groups(P<0.05).The CT value of the ascending aorta in the LDCT group was lower than that in the conventional FBP group.The CT value SD of the ascending aorta in all the LDCT group,except for the ADMIRE 5 group,was higher than that in the conventional FBP group.The SD of the CT values of the ascending aorta decreased gradually with the increase of ADMIRE intensity in LDCT,and the difference was statistically significant(P<0.05).Compared to the LDCT ADMIRE 5 group,the SNR of the conventional FBP group was higher than that of the LDCT FBP group,LDCT ADMIRE 1 group and LDCT ADMIRE 3 group,however there were no significant differences.The CNR of the conventional FBP group was lower than that of the LDCT group,and the CNR of the LDCT group gradually increased with an increase in the ADMIRE intensity,exhibiting a statistically significant difference(P<0.05).The Agatsto

关 键 词：冠状动脉钙化 迭代重建 低剂量 能谱纯化 计算机体层成像 

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