实影渲染重建技术在急性肺动脉栓塞中的初步应用  

the Preliminary Application of Cinematic Rendering Reconstruction Technology in Acute Pulmonary Embolism

作　　者：刘忠啸 于孟 张贺 邱慎满 王梓又 徐文北 谢丽响 王浩 孟闫凯 孙存杰 徐凯 LIU Zhongxiao;YU Meng;ZHANG He(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医学影像科,221002 [2]徐州医科大学医学影像学院,221002 [3]江苏省医学影像与数字医学工程研究中心,221002 [4]徐州医科大学附属睢宁县人民医院影像科,221002

出　　处：《临床放射学杂志》2024年第3期383-387,共5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(2021008));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 分析实影渲染(CR)重建技术在急性肺动脉栓塞(APE)患者中的临床应用价值。方法 回顾性分析行CT肺血管造影检查的APE患者资料。将图像上传至Siemens Syngo.via后处理工作站,由一名从事心血管影像诊断工作的医师根据预先设计好的APE渲染颜色、透明度模块分别进行CR、容积再现(VR)重建。所有后处理图像的主观评估均由两名从事影像诊断工作的高级职称医师讨论进行,意见不一致时,由另一名从事心血管方向的更高职称医师判读。后处理图像的主观评估采用3分法,包括图像质量方面的栓子显示、解剖结构评分,对栓子的诊断信心及是否推荐用于多学科诊疗模式(MDT)。结果 本研究共纳入17例患者,平均年龄(72.1±11.2)岁。13例(76.5%)患者CR重建栓子显示为3分。CR重建栓子显示平均2.647分,VR 2.059分,差异具有统计学意义(P=0.004)。所有病例CR重建的解剖结构均为3分,明显高于VR(2.059分),P<0.001。13例(76.5%)患者CR重建图像栓子诊断信心为3分,明显高于VR,分别为2.647和1.706分(P<0.001)。14例(82.4%)患者CR重建图像被推荐用于MDT(3分),9例(52.9%)VR组图像可推荐用于MDT讨论(2分),两组间差异有统计学意义(P<0.001)。结论 CR能够提供逼真的解剖级后处理图像,能够更好地显示APE、提高诊断信心、用于MDT交流。Objective To analyze the clinical application value of cinematic rendering(CR) technology in patients with acute pulmonary embolism(APE).Methods Patients suspected APE who underwent CT pulmonary angiography(CTPA) were retrospectively analyzed.Images of all patients were uploaded to Siemens Syngo.via post-processing workstation(Siemens Healthcare,Germany) and were post-processed with CR and volume rendering(VR) technique utilizing predefined rendering protocols which including staining and transparency settings by an experienced radiologist engaged in cardiovascular diagnosis,respectively.The subjective image quality of all post-processed CR and VR images were evaluated and scored by two senior radiologists after discussion.When the results failed to reach a consensus,a more experienced senior radiologist engaged in cardiovascular diagnosis drew the final conclusion.The 3-point scale were used in subjective evaluation of post-processing images including scores of embolism visualization,anatomical details,confidence of embolism diagnosis and recommendation rate for multi-disciplinary treatment(MDT).Results Seventeen patients were enrolled with average age of(72.1±11.2) years old.CR reconstruction in 13 patients(76.5%) were scored full points(3 pts) in embolism visualization.The average scores of embolism visualization of CR and VR were 2.647 points and 2.059 points,respectively,and showed statistical significance(P= 0.004).CR reconstruction in 13 patients(76.5%) were scored 3 points in confidence of embolism diagnosis,which were significantly higher than VR reconstruction(2.059 pts),with P<0.001.Fourteen patients(82.4%) under CR reconstruction were highly recommended to use in MDT(scored as 3 points),where 9 patients(52.9%) under VR reconstruction were moderately recommended to use in MDT(scored as 2 points).The difference between 2 groups showed statistical significance(P<0.001).Conclusion CR provides photorealistic anatomic post-processing image,which showed better visualization of APE and improvement of diagnos

关 键 词：急性肺动脉栓塞 CT肺血管造影 图像后处理 容积重建 实影渲染 

分 类 号：R563.5[医药卫生—呼吸系统]