全心运动追踪冻结算法(SSF2)对经导管主动脉瓣植入术术前主动脉瓣环CT评估的图像质量及测量一致性影响  

Impacts of whole heart motion correction algorithm(second-generation snapshot freeze)on image quality and measuring consistency in pre-TAVR aortic annulus CT evaluation

作　　者：吴乃明 卢庆 王憬 宫泽 陈素萍 赵恒宇 WU Nai-ming;LU Qing;WANG Jing(Department of Imaging,Xiamen Cardiovascular Hospital of Xiamen University,School of Medicine,Fujian 361000,China)

机构地区：[1]厦门大学附属心血管病医院影像科,福建361000 [2]美国通用电气医疗系统贸易发展有限公司,上海200000

出　　处：《放射学实践》2024年第6期746-754,共9页Radiologic Practice

基　　金：厦门市科技计划项目(3502Z202373114)。

摘　　要：目的:评估全心运动追踪冻结技术(snapshot freeze 2.0,SSF 2)能提高在心脏增强计算机断层扫描(CT)中对经导管主动脉瓣植入术(TAVR)术前患者主动脉瓣环CT测量一致性和图像质量的影响。方法:回顾性分析2020年12月-2021年8月期间57例主动脉瓣疾病患者用于TAVR术前评估的心脏增强CT患者检查影像学资料。所有患者在自由心率下在单次心跳期间接受前瞻性ECG门控同步采集的心脏增强CT检查。分别使用冠状动脉运动追踪冻结技术(snapshot freeze 1.0,SSF 1)和SSF 2后处理技术从R-R间隔获取的35%和75%的原始数据中获得后处理图像。每个患者的4组图像(SSF 1-35%、SSF1-75%,SSF 2-35%、SSF2-75%)由两个独立的盲读者测量分析主动脉瓣环面积、短轴和长轴、周长、平均直径和左、右冠状动脉高度并对整体图像质量使用5分Likert法进行主观评分。测量主动脉瓣环,左、右冠脉开口处的CT值、SD值,计算信号噪声比和对比噪声比。比较分析图像质量和测量一致性。结果:无论在35%还是75%期相,SSF2组图像均具有比SSF1图像更高的图像评分(P<0.05),35%期相时SSF2将图像质量从不可评估(<3分)提高至了良好(≥4分)。客观参数上在35%期相SSF2图像主动脉瓣环SD更低,75%期相左冠开口SNR更高(P<0.05)。对于同一位医师SSF1图像与SSF2图像上测得的主动脉瓣环参数无统计学差异(P>0.05)。一致性分析显示35%期相图像上测量主动脉瓣环的环长轴、环短轴、平均直径、周长和面积时,SSF2图像能获得比SSF1图像更窄的Bland-Altman一致性区间(LOA)和更高的组内相关系数(ICC),但无统计学意义。75%期相图像上SSF2能提高测量平均直径,面积,左、右冠脉高度的一致性,其中对于左冠高度测量有统计学意义[SSF1-75%vs.SSF2-75%,测量偏差:-0.2246 vs.-0.3211,LOA:(-3.411,2.962)vs.(-2.034,1.392),ICC:0.892 vs.0.966,95%置信区间:(0.824,0.935)vs.(0.943,0.98)]。结论:SSF 2可显著减少�Objective:To evaluate the impacts of whole heart motion correction algorithm(snapshot freeze 2.0,SSF2)on image quality and measuring consistency in contrast-enhanced cardiac computed tomography(CT)imaging for pre-TAVR aortic annulus CT evaluation.Methods:The CT datasets of 57 patients(from 2020 Dec.to 2021 Aug.)with aortic valve diseases for pre-TAVR evaluation were retrospectively analyzed.All patients without control of heart rate were proceeded prospective ECG triggering contrast enhanced cardiac CT scan within a single beat.The images acquired at 35% and 75% R-R interval were both post-processed by coronary artery motion correction algorithm(snapshot freeze 1.0,SSF1)and SSF2,thus four data sets(SSF1-35%,SSF1-75%,SSF2-35%,SSF2-75%)were obtained.The measurement of area,short/long axis,perimeter,mean diameter,left and right coronary height were performed by two independent radiologists blinded to the reconstruction information.The subjective evaluation on overall image quality was also conducted by them using 5-point Likert score.CT values and SD values on aortic annulus,openings of left coronary and right coronary were measured,then signal to noise ratio(SNR)and contrast to noise ratio(CNR)were measured.Then the image quality and measuring consistency were compared.Results:SSF2 images had higher subjective scores than SSF1 images(P<0.05)at both 35% and 75% R-R intervals,therein,for images acquired at 35% R-R interval,SSF2 improved the subjective image scoring from non-interpretable(<3 points)to good(≥4 points).In terms of objective image quality,at 35% phase,SSF2 images had lower SD on aortic annulus,and at 75% phase,SSF2 images had higher SNR on opening of left coronary(both P<0.05).For the specific radiologist,the measurements of aortic annulus were not statistically different between SSF1 and SSF2 images(all P>0.05).As shown in consistency analysis,for images acquired at 35% R-R interval,SSF2 images resulted in narrower limit of agreement(LOA)in Bland-Altman results and higher interclass correlation coeffi

关 键 词：主动脉瓣 经导管主动脉瓣置换 体层摄影术 X线计算机 

分 类 号：R322.11[医药卫生—人体解剖和组织胚胎学] R654.27[医药卫生—基础医学] R814.42