探讨双低方案联合深度学习重建算法在大体重患者胸腹主动脉CTA中的应用价值  

Study of Double-low CT Scanning Protocol Combined with Deep Learning Image Reconstruction for Thoracoabdominal Aorta CTA Scanning in Overweight Patients

作　　者：李正正 白雪 曹永佩 高永斌[2] 陈大治[2] 汪芳[2] 杨蔚[1,3] LI Zhengzheng;BAI Xue;CAO Yongpei;GAO Yongbin;CHEN Dazhi;WANG Fang;YANG Wei(First Clinical Medical College,Ningxia Medical University,Yinchuan 750000,China;Medical Imaging Center,Ningxia Hui Autonomous Region People's Hospital;Department of Radiology,Tumor Hospital of General Hospital,Ningxia Medical University,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学第一临床医学院,银川750002 [2]宁夏回族自治区人民医院医学影像中心 [3]宁夏医科大学总医院肿瘤医院放射科,银川750002

出　　处：《中国医学计算机成像杂志》2025年第1期99-106,共8页Chinese Computed Medical Imaging

摘　　要：目的:探讨CT双低方案(70 kV管电压+低浓度对比剂)联合深度学习图像重建(DLIR)算法在大体重患者胸腹主动脉CT血管成像(CTA)扫描中的可行性。方法:前瞻性收集我院2023年1—12月疑似为主动脉疾病并接受胸腹主动脉CTA检查的患者60例,按照体重指数(BMI)值<24 kg/m^(2)或≥24 kg/m^(2)分为A组(标准体重)和B组(大体重)[A组:男23例,女7例,BMI平均值(22.50±1.30)kg/m^(2);B组:男25例,女5例,BMI平均值(26.30±1.97)kg/m^(2)],每组各30例。基于管电压、碘对比剂、重建算法的选用规则,A组接受常规方案(100 kV+碘普罗胺370 mgI/mL+50%ASIR-V算法),B组接受双低方案(70 kV+碘克沙醇320 mgI/mL+DLIR-H算法、50%ASIR-V算法)。结果:双低方案扫描下,B组中胸腹主动脉各层面(主动脉弓、三尖瓣、腹腔干、肠系膜下动脉、髂动脉分叉)CT值均高于A组同等层面,差异具有统计学意义(均P<0.001),而组内CT值无统计学差异(P>0.05);B组中DLIR-H重建降噪能力最强,图像的客观评分和主观评分最高,差异具有统计学意义(均P<0.05),DLIR-H图像表现最佳;与A组相比,B组中DLIR-H图像的平均SD值降低18.5%,CNR值、SNR值及主观评分均高于A组,50%ASIR-V图像的各层面SD值高于A组(P<0.05),但图像各层面的CNR值、SNR值和主观评分与A组无统计学差异(P>0.05);A组和B组有效辐射剂量分别为(9.21±2.49)mSv和(6.52±0.63)mSv,B组有效辐射剂量较A组降低33.2%,而有效碘摄入量与其相当(P>0.05)。结论:使用GE Revolution Apex CT的双低扫描方案联合DLIR可用于大体重患者胸腹主动脉CTA扫描,不仅可以降低患者的辐射剂量及碘剂量,而且可以提高图像质量和诊断信心。Purpose:To explore the feasibility of a double-low CT scanning protocol[low tube voltage(70 kV)and low contrast agent concentration]combined with deep learning image reconstruction(DLIR)for thoracoabdominal aorta CT angiography(CTA)scanning in overweight patients.Methods:From January to December 2023,60 patients suspected of aortic disease underwent thoracoabdominal aorta CTA scans in our hospital were enrolled in the study.According to body mass index(BMI),they were divided into two groups:group A(normal body weight,BMI<24 kg/m^(2))and group B(overweight,BMI≥24 kg/m^(2)).Group A consisted of 23 males and 7 females with a mean BMI of(22.50±1.30)kg/m^(2),while group B included 25 males and 5 females with a mean BMI of(26.30±1.97)kg/m^(2).Based on the selective rules of the tube voltage,iodine contrast agent,and reconstruction algorithm,group A used a conventional protocol(tube voltage of 100 kV,370 mgI/mL iopramine,and 50%ASIR-V algorithms),and group B used a double-low protocol(tube voltage of 70 kV,320 mgI/mL iohexol,and DLIR-H and 50%ASIR-V algorithms).Results:Group B was with higher CT values for the thoracoabdominal aorta(aortic arch,tricuspid valve,abdominal aorta,inferior mesenteric artery,iliac artery bifurcation)compared to group A,and the differences were with statistical significance(P<0.001).In group B,the noise reduction ability of DLIR-H algorithms was the best,and both objective and subjective image scores were the highest,the quality of the DLIR-H images was the best.Compared with group A,the average SD value of DLIR-H images was decreased by 18.5%,and the DLIR-H images were with higher CNR value,SNR value,and subjective scores compared to group A.The SD values of 50%ASIR-V images were higher than those of group A(P<0.05),but the CNR values,SNR values and subjective scores showed no statistical difference between group A and group B(P>0.05).The effective radiation doses in group A and group B were(9.21±2.49)mSv and(6.52±0.63)mSv,respectively.The effective radiation dose in group B was 33.2%lo

关 键 词：超重 双低扫描方案 深度学习重建 胸腹主动脉 CT血管成像 

分 类 号：R445.3[医药卫生—影像医学与核医学]