全模型迭代重建在不同冠状动脉狭窄程度患者低管电压冠状动脉CTA图像中的应用  

Application of iterative model reconstruction in low-dose coronary computer tomography angiography imaging for patients with different degrees of coronary artery stenosis

作　　者：陈静霞 袁莹 王晰光 Chen Jingxia;Yuan Ying;Wang Xiguang(Xingtai Central Hospital,Xingtai 054000,China)

机构地区：[1]河北省邢台市中心医院,054000

出　　处：《心脑血管病防治》2025年第1期4-7,40,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：邢台市重点研发计划项目(2021ZC099)。

摘　　要：目的探讨基于全模型迭代重建(IMR)的冠状动脉计算机断层摄影血管造影术(CTA)在冠心病患者图像成像中的应用以及对不同狭窄程度的诊断效能。方法选取2020年1月到2022年12月在邢台市中心医院行CTA检查的140例确诊冠心病患者为研究对象。所有患者均在80 kV管电压下进行CT扫描,分别根据IMR算法和滤波反投影法(FBP)算法进行图像重建,比较两种算法的图像质量和诊断效能。结果IMR算法在左冠状动脉前降支远段、左冠状动脉回旋支远段和右冠状动脉远段的图像主观评分高于FBP算法,差异有统计学意义(t=6.367、3.310、2.537,P<0.05),其它血管差异无统计学意义(P>0.05)。两种算法冠状动脉各节段CT值无统计学意义(P>0.05),但IMR算法的标准差低于FBP算法,差异有统计学意义(P<0.01),IMR算法冠状动脉各节段的对比噪声比高于FBP算法,差异有统计学意义(P<0.01)。以冠状动脉造影结果为金标准,在节段水平上IMR算法对不同狭窄程度冠状动脉诊断的敏感度为92.24%、特异度为91.19%、准确度为91.82%,FBP算法对不同狭窄程度冠状动脉诊断的敏感度为81.17%、特异度为80.43%、准确度为80.88%,差异有统计学意义(P<0.05)。结论在低管电压条件下,IMR算法能减少噪声提高血管远段图像质量,对不同狭窄程度的冠状动脉节段均有良好的诊断效能。Objective To explore the application of coronary computed tomography angiography(CTA)imaging based on iterative model reconstruction(IMR)in the imaging of patients with coronary heart disease(CHD)and its diagnostic efficacy for different degrees of stenosis.Methods A total of 140 CHD patients who underwent CTA examination at Xingtai Central Hospital from January 2020 to December 2022 were selected as the research subjects.All patients underwent CT scanning with 80 kV tube voltage,and images were reconstructed using the IMR algorithm and the filtered back projection(FBP)algorithm,respectively.Image quality and diagnostic performance of the two algorithms were compared.Results The subjective scores of IMR algorithm in the distal segment of left anterior descending artery(LAD),left circumflex artery(LCX)and right coronary artery(RCA)were significantly higher than those of the FBP algorithm(t=6.367,3.310,2.537;P<0.05),and there was no statistically significant difference in other blood vessels(P>0.05).The CT values of different coronary segments between the two algorithms showed no significant difference(P>0.05),but the standard deviation values of the IMR algorithm were significantly lower than those of FBP(P<0.01),and the contrast to noise ratio values were significantly higher(P<0.01).Taking coronary angiography as the gold standard,the sensitivity,specificity,and accuracy of the IMR algorithm for diagnosing different degrees of coronary stenosis at the segment level were 92.24%,91.19%,and 91.82%,respectively,while those of the FBP algorithm were 81.17%,80.43%,and 80.88%,respectively,with statistically significant differences(P<0.05).Conclusion Under low tube voltage conditions,the IMR algorithm can reduce noise and improve image quality of distal coronary segments,offering good diagnostic performance for coronary segments with different degrees of stenosis.

关 键 词：全模型迭代重建 滤波反投影法 冠心病 计算机断层摄影血管造影术 图像质量 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]