低剂量容积动态时相重建术在肺动脉CT血管成像中的运用价值  

Application Value of Low Dose Iodine Contrast Agent Volumetric Time-phase Reconstruction Technique in Pulmonary Artery CT Angiography

作　　者：徐翔[1] 宋彬[1] 申晋疆 雷岩[1] 刘恋恋 XU Xiang;SONG Bin;SHEN Jingjiang;LEI Yan;LIU Lianlian(Department of Radiology,Minhang Hospital,Fudan University,Shaghai 201100,China)

机构地区：[1]复旦大学附属闵行医院(上海市闵行区中心医院)放射科,上海201100

出　　处：《中国医学计算机成像杂志》2023年第1期96-101,共6页Chinese Computed Medical Imaging

摘　　要：目的:探讨基于低剂量容积CT动态时相重建技术改善肺动脉CT血管成像图像质量的可行性.方法:前瞻性收集2020年1月至2021年12月间临床拟诊肺动脉栓塞行肺动脉CT血管成像的患者,随机分为A组和B组,分别行动态CT血管成像和标准CT血管成像,A组根据重建方式又分为3个亚组,即A1组(动态CT血管成像动脉期重建)、A2组(时相血管成像重建)和A3组(4D降噪时相血管成像重建).分别在A组各亚组和B组图像的肺动脉干及各级分支选取感兴趣区域,测定血管腔CT值、噪声,并计算信噪比(SNR)和对比噪声比(CNR).采用5分法对肺动脉血管的图像质量作出主观评价,统计分析客观指标与主观评价.结果:A组血管腔CT值、噪声、SNR、CNR均高于B组,差异均有统计学意义(P<0.05).A组各亚组的血管腔CT值均高于B组,差异有统计学意义(均P<0.001),以A2组最高;噪声值仅A1组与B组间差异有统计学意义(P=0.009);SNR在A2组、A3组与B组间差异均有统计学意义(P=0.031,P=0.007),以A3组最高;CNR仅A3组与B组间差异有统计学意义(P=0.038).A组和B组的肺动脉可诊断率、图像质量主观评分差异均有统计学意义(P<0.001);A2组和A3组的肺动脉可诊断率均为100%;A2组和A3组的图像质量主观评分与其余各组比较,差异均有统计学意义,A2组和A3组之间差异无统计学意义.结论:低剂量容积动态时相重建技术可明显改善肺动脉CT血管成像图像质量,尤其可提高肺动脉亚段以下5、6级分支的显示质量,有利于肺栓塞的诊断.Purpose:To explore the feasibility of improving the image quality of pulmonary artery CT angiography based on low-dose volume CT dynamic phase reconstruction technique.Methods:Patients who were clinically diagnosed with pulmonary embolism and underwent pulmonary artery CT angiography from January 2020 to December 2021 were prospectively enrolled.They were randomly undergone dynamic CT angiography(group A)and standard CT angiography(group B).Patients in group A were divided into three subgroups according to different reconstruction methods:group A1(arterial phase reconstruction of dynamic CT angiography),group A2(phase reconstruction of dynamic CT angiography)and group A3(4D noise reduction phase reconstruction of CT angiography).The regions of interest were selected from the pulmonary trunk and its branches in each subgroup of group A and in group B,respectively.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.The image quality of pulmonary artery was subjectively evaluated by five-point scale,and the objective indexes and subjective evaluation were statistically analyzed.Results:There were significant differences in CT attenuation, noise, SNR and CNR between group A and group B (P<0.05). The vessel CT value of group A2 was themost significantly higher than that of group B (P<0.001). The noise value of group B was significantly lower thanthat of group A1 (P=0.009). The SNR of group A3 was significantly higher than that of group B (P<0.05). The CNRof group B was significantly lower than that of group A3 (P=0.038). The diagnostic rate of pulmonary artery andsubjective evaluation of image quality between group A and group B were with statistical significance (P<0.001), andthe diagnostic rate of group A2 and A3 was 100%.Conclusion: Low-dose volume dynamic phase reconstructiontechnique can be used to significantly improve the image quality of pulmonary artery CT angiography, especiallyimprove the visualization quality of grade 5 and 6 branches of the pulmonary artery below the subsegment,

关 键 词：动态CT CT血管成像 肺动脉 

分 类 号：R814.3[医药卫生—影像医学与核医学]