单能量去金属伪影技术在腹主动脉瘤腔内修复术联合弹簧圈栓塞术后CTA复查中的应用价值  

Application value of single energy metal artifact reduction in the follow-up CT angiography after endovascular repair of abdominal aortic aneurysm combined with coil embolization

作　　者：张瑛 周淳 刘诚 侯凯 ZHANG Ying;ZHOU Chun;LIU Cheng;HOU Kai(Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Medical Imaging,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放射科,上海200032 [2]上海市医学影像研究所,上海200032

出　　处：《中国临床医学》2024年第6期984-989,共6页Chinese Journal of Clinical Medicine

基　　金：上海市科学技术委员会项目(23Y11907400).

摘　　要：目的探讨320排CT螺旋扫描模式下应用单能量去金属伪影技术(single energy metal artifact reduction,SEMAR)在复杂腹主动脉瘤腔内修复术(endovascular aortic repair,EVAR)联合弹簧圈瘤体栓塞术后CTA复查中的应用价值。方法回顾性分析2023年8月至2024年2月在复旦大学附属中山医院行EVAR联合弹簧圈瘤体栓塞术后30 d行腹部CTA复查的14例腹主动脉瘤患者和2例髂内动脉瘤患者的CTA图像。对原始数据分别用混合迭代重建算法(non-SEMAR组)和联合SEMAR算法(SEMAR组)进行重建,对比两组图像伪影指数(artifact index,AI)、伪影周围对比噪声比(contrast-to-noise ratio,CNR)和主观评分。结果SEMAR组弹簧圈上、下、左、右和邻近主动脉腔内的AI值均低于non-SEMAR组(38.16±19.20 vs 89.29±30.93、30.75±16.28 vs 82.62±28.01、33.61±16.18 vs 74.90±26.28、44.99±15.91 vs 87.72±33.70和24.49±12.58 vs 47.29±13.55,P<0.001);SEMAR组各方位CNR高于non-SEMAR组(2.47±2.15 vs 1.01±0.74、2.32±2.01 vs 0.72±0.50、4.93±4.15 vs 1.38±0.79、4.10±4.14 vs 1.56±1.18和19.91±11.01 vs 11.01±7.77,P<0.05)。与non-SEMAR组相比,SEMAR组图像主观评分明显增加(P<0.001)。结论SEMAR技术可减少弹簧圈伪影,提高瘤体、内脏动脉、支架和内漏显示的清晰度,对EVAR术后随访有重要临床意义。Objective To explore the application value of single energy metal artifact reduction technology(SEMAR)in the CTA follow-up of complex abdominal aortic aneurysm endovascular repair(EVAR)combined with coil embolization using 320-slice CT spiral scanning mode.Methods A retrospective analysis was conducted on the images of 14 patients with abdominal aortic aneurysm and 2 patients with internal iliac artery aneurysm who underwent abdominal CTA reexamination 30 days after EVAR combined with coil embolization at Zhongshan Hospital,Fudan University from August 2023 to February 2024.The original data were reconstructed using a hybrid iterative reconstruction algorithm(non-SEMAR group)and a combined reconstruction and SEMAR algorithm(SEMAR group),and the artifact index(AI),contrast-to-noise ratio(CNR),and subjective scores between the two groups were compared.Results The AI values of up,down,left,right around the spring coil and adjacent aortic cavity in the SEMAR group were lower than those in the non-SEMAR group(38.16±19.20 vs 89.29±30.93,30.75±16.28 vs 82.62±28.01,33.61±16.18 vs 74.90±26.28,44.99±15.91 vs 87.72±33.70,and 24.49±12.58 vs 47.29±13.55;P<0.001),and the CNRs in the SEMAR group were higher than those in the non-SEMAR group(2.47±2.15 vs 1.01±0.74,2.32±2.01 vs 0.72±0.50,4.93±4.15 vs 1.38±0.79,4.10±4.14 vs 1.56±1.18,and 19.91±11.01 vs 11.01±7.77;P<0.05).Compared with the non-SEMAR group,the subjective scores of image in the SEMAR group were higher(P<0.001).Conclusions SEMAR technology can significantly reduce the artifact of spring coil,improve the clarity of tumors,visceral arteries,stents,and internal leaks images,and has important clinical significance for follow-up after EVAR surgery.

关 键 词：腹主动脉瘤 髂内动脉瘤 单能量去金属伪影技术 CT血管造影 腹主动脉瘤腔内修复术 

分 类 号：R732.2[医药卫生—肿瘤]