不同管电压对超高分辨光子计数探测器CT评估冠状动脉支架的影响:一项体模研究  

Impact of different tube voltages on the evaluation of coronary artery stents with ultra-high-resolution photon-counting detector CT:a phantom study

作　　者：孙越 徐橙 邹丽淼 王明[1] 俞贤博 于扬 王怡宁[1] SUN Yue;XU Cheng;ZOU Limiao;WANG Ming;YU Xianbo;YU Yang;WANG Yining(Department of Radiology,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;CT Collaboration,Siemens Healthineers Ltd.)

机构地区：[1]中国医学科学院北京协和医学院疑难重症和罕见病国家重点实验室北京协和医院放射科,北京100730 [2]西门子医疗有限公司CT合作部

出　　处：《国际医学放射学杂志》2024年第6期642-646,共5页International Journal of Medical Radiology

基　　金：北京市自然科学基金重点研究专题项目(Z210013);中国医学科学院医学与健康科技创新工程项目(2023-12M-C&T-A-004);国家杰出青年科学基金(82325026)。

摘　　要：目的 探讨不同管电压对超高分辨光子计数探测器CT(PCD-CT)评估冠状动脉支架的影响。方法 选取6枚直径约3 mm的不同材质的冠状动脉支架,置入人造模拟冠状动脉血管内,分别采用140 kV和120 kV管电压以相对于扫描设备z轴0°和90°方向对支架行超高分辨PCD-CT扫描。通过不同的扫描和重建参数组合完成144组影像数据的采集。对全部影像进行主观评分及客观影像质量评价。客观影像评价包括支架腔内衰减增加比率(SAIR)、支架的边缘上升距离(ERD)和支架内径。采用Cohen’s Kappa检验评估影像质量主观评分的观察者间一致性。采用配对t检验或Wilcoxon检验比较2种管电压下0°和90°方向支架的影像质量指标。采用多因素广义线性混合效应模型分析高管电压(140 kV)对冠状动脉支架影像定性定量评估的影响。结果 对于0°方向支架,120 kV和140 kV管电压下扫描获得的冠状动脉支架影像的影像质量主观评分、SAIR值、ERD值及支架内径差异均无统计学意义(均P>0.05)。对于90°方向支架,140 kV相比120 kV管电压下的支架影像具有更高的SAIR值、更低的ERD值及更大的支架内径(均P<0.05)。对于0°和90°方向支架,140 kV均可增加SAIR值(均P<0.05);而对于90°方向支架,140 kV还能提高支架内直径测量值,减小ERD值(均P<0.05)。结论 140 kV相较120 kV管电压可降低超高分辨PCD-CT上的冠状动脉支架硬化线束伪影。当冠状动脉支架相对于z轴的角度增加,高管电压可进一步增加支架锐利度及支架内径。但高管电压可增加辐射剂量,临床应用中仍需综合评估。Objective To investigate the impact of different tube voltages on the evaluation of coronary stents using ultra-high-resolution(UHR)photon-counting detector computed tomography(PCD-CT).Methods Six stents,approximately 3 mm in diameter and made from different materials,were placed inside artificial coronary vessel phantoms.UHR-PCD-CT scans of the stent were performed using different tube voltages(140 kV and 120 kV)and orientations(0°and 90°)relative to the z-axis of the scanning device.A total of 144 image datasets were acquired using various combinations of scanning and reconstruction parameters.Subjective scores and objective image quality were assessed.Objective metrics included the stent lumen attenuation increase ratio(SAIR),edge rise distance(ERD),and inner diameter of the stent.Inter-observer agreement for subjective image quality scoring was assessed using Cohen’s Kappa test.Paired-sample t-tests or Wilcoxon tests were used to compare the image quality metrics of stents at different orientations(0°and 90°)under the two tube voltages.Multivariate generalized linear mixed-effects models were employed to investigate the impact of high tube voltage(140 kV)on the evaluation of coronary stents.Results For stents in the 0°orientation,no statistically significant differences were observed in subjective image quality scores,SAIR values,ERD values,and in-stent diameters between scans at 120 kV and 140 kV tube voltage (all P>0.05). For stents in the 90° orientation, imaging at 140 kV resulted in higher SAIR values, lower ERD values, and larger in-stent diameters compared to 120 kV (all P<0.05). For both 0° and 90° orientations, 140 kV significantly increased SAIR values (both P<0.05). Additionally, for stents in the 90° orientation, 140 kV increased the measured in-stent diameter and reduced ERD values (both P<0.05). Conclusions Compared to 120 kV, a tube voltage of 140 kV can reduce beam hardening artifacts associated with coronary stents in UHR-PCD-CT imaging. As the angle of the coronary stent relative

关 键 词：管电压 冠状动脉支架 超高分辨率 光子计数探测器CT 体模 

分 类 号：R814.42[医药卫生—影像医学与核医学] R816.2[医药卫生—放射医学]