比较双低扫描深度学习重组、能谱成像单能量重组CTPA图像质量、辐射剂量  

To Compare the Imaging Quality and Radiation Dose of Double-Low Scanning Mode with Deep Learning Image Reconstruction(DLIR)and Spectral Imaging with Monochromatic Reconstruction in CT Pulmonary Angiography(CTPA)

作　　者：张贺 刘忠啸 孟闫凯 程晓奕 李新秀 鲍毓 邱慎满 聂驿 朱慧慧 丁涛 张艳春[5] 王浩[5] 石骁萌 张帅 孙存杰 徐凯 ZHANG He;LIU Zhongxiao;MENG Yankai(Department of Radiology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,Province 221002,P.R.China.)

机构地区：[1]徐州医科大学附属医院影像科,221002 [2]徐州医科大学影像学院,221002 [3]徐州医科大学医学影像与数字医学研究所,221002 [4]GE中国CT影像研究中心,上海200000 [5]睢宁县人民医院,徐州221225

出　　处：《临床放射学杂志》2023年第8期1258-1264,共7页Journal of Clinical Radiology

基　　金：江苏省医学会科研专项资金项目(编号:SYH-3201150-0013);江苏省中医药科技发展计划项目(编号:MS2021100);徐州市科学技术局重点研发计划(社会发展)(编号:KC20159);江苏省卫生健康委老年健康科研项目(编号:LKM2022018)。

摘　　要：目的比较双低扫描(低千伏、低剂量对比剂)深度学习重组(DLIR)与能谱成像单能量重组CT肺动脉造影(CTPA)的图像质量、辐射剂量。方法回顾性分析2021年9月至2022年3月本院行CTPA检查的患者资料。根据扫描方式将患者随机分为DLIR组[管电压80 kV,DLIR高档(DL-H)算法重组]、能谱组(80/140 kV瞬切能谱扫描模式,50%ASIR-V算法重组),并固定两组扫描模式的噪声指数以及对比剂剂量一致。两组对比剂(碘海醇350 mgI/ml)注射剂量均为20 ml,注射流率4.5 ml/s。利用能谱分析软件分别重组40 keV、50 keV、60 keV、70 keV四组单能量图像,比较各组单能量图像质量,获得能谱成像最佳单能量序列。比较DLIR、能谱最佳单能量成像肺动脉及其主要分支CT值、图像噪声、信噪比(SNR)、对比噪声比(CNR)以及图像质量主观评分、诊断信心。分别记录CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(ED)等。结果共纳入60例患者,DLIR组、能谱组各30例。40 keV、50 keV、60 keV、70 keV四组单能量图像中,40 keV组肺动脉主干、左右肺动脉干CT值、图像噪声最高,且随着keV的增加而降低。60 keV单能量图像CNR最高,为最佳单能量图像。DLIR组肺动脉主干、左右肺动脉干、左上、左下肺动脉干、右上、右下肺动脉干的CT值、SNR、CNR均高于60 keV组,差异具有统计学意义(P<0.05)。DLIR组的主观评分、诊断信心较60 keV组分别增加32.4%、16.7%,差异具有统计学意义(P<0.01)。DLIR组辐射剂量参数CTDIvol、DLP及ED较60 keV组分别降低约56%、61%、61%,差异均具有统计学意义(P<0.01)。结论CTPA双低扫描模式中,DLIR的图像质量、辐射剂量优于能谱成像60 keV单能量重组。Objective To compare the imaging quality and radiation dose of double-low scanning mode(low kilovol tube voltage and low dose contrast agent)with deep learning image reconstruction(DLIR)and spectral imaging with monochromatic reconstruction in CT pulmonary angiography(CTPA).Methods Patients performed CTPA between September 2021 and March 2022 in our institution were retrospectively analyzed.All patients were randomly recruited into DLIR group[80 kV tube voltage,DLIR High(DL-H)algorithm reconstruction]and energy spectrum group[energy spectrum scanning mode,with 50%adaptive statistical iterative reconstructions-V(ASIR-V)algorithm reconstruction].The dose of contrast agent(350 mg/ml)in both groups was 20 ml with 4.5 ml/s injection rate.The 40,50,60 and 70 keV monochromatic images were respectively reconstructed using energy spectrum analysis software.The imaging quality of four different monochromatic imaging were compared to select the optimal monochromatic sequence of energy spectrum scanning.The objective image quality[CT values,imaging noise,signal noise ratio(SNR)and contrast noise ratio(CNR)]and subjective image quality(imaging quality subjective scoring and diagnostic confidence)of pulmonary artery main trunk and branches were analyzed and compared between two groups.The dose index(CTDIvol),dose length product(DLP)and effective radiation dose(ED)were recorded and used for analysis.Results 60 patients were enrolled in this study.Each of the DLIR and energy spectrum group enrolled 30 patients,respectively.The CT value and the imaging noise decreased while keV ranged from low to high.The CT value and the imaging noise of pulmonary trunk,left and right pulmonary trunk were highest in 40 keV monochromatic imaging.The optimal CNR was detected in 60 keV monochromatic imaging.So,the 60 keV was the best monochromatic sequence of energy spectrum scanning.The CT values,SNR and CNR(pulmonary main trunk,left and right pulmonary trunk,left upper and left lower pulmonary trunk,right upper and right lower pulmonary trunk)in

关 键 词：CT肺动脉造影 深度学习重组 能谱CT 单能量图像 辐射剂量 

分 类 号：R816.2[医药卫生—放射医学]