O-MAR联合迭代重建技术在腰椎内固定术后CT成像中的应用  

Orthopedic Metal Artifact Reduction Combined with Iterative Reconstruction in CT Imaging after Lumbar Internal Fixation

作　　者：程天馨 张永县[3] CHENG Tianxin;ZHANG Yongxian(Yanjing Medical College,Capital Medical University,Beijing 101300,China;Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学燕京医学院,北京101300 [2]首都医科大学附属北京友谊医院放射科,北京100050 [3]首都医科大学附属北京同仁医院放射科,北京100730

出　　处：《CT理论与应用研究(中英文)》2025年第2期285-293,共9页Computerized Tomography Theory and Applications

摘　　要：目的:探讨金属伪影抑制技术(O-MAR)联合迭代算法对腰椎内固定术后患者CT图像质量的影响,为术后效果评估提供准确依据。方法:回顾性分析20例行腰椎内固定术后CT检查,使用O-MAR和滤波反投影算法、iDose^(4)重建骨算法图像(iDose^(4)-1~7级)及软组织算法图像(iDose^(4)-1~6级)。重组螺钉显示最佳的横断面和矢状面的骨算法图像及螺钉显示最佳及螺钉区域内椎间盘正中层面的横断面软组织算法图像,测量骨质和肌肉的噪声值(SD)并计算伪影指数(AI)。由两名放射科医师对骨及软组织算法图像的金属伪影抑制和诊断信息显示两方面分别评分。对主客观评价指标进行两组间比较和组间多重比较。结果:骨算法图像:使用O-MAR的图像SD、AI显著低于未使用的图像,不同等级iDose^(4)图像的AI值随等级升高而逐渐降低;O-MAR图像金属伪影主观分显著提高,且iDose^(4)-5~7评分高于FBP及iDose^(4)-1~2;使用O-MAR时诊断信息评分显著提高,i Dose4-2~4评分高于FBP及其他迭代等级,且iDose^(4)-3为最佳。软组织算法图像:使用O-MAR的图像SD、AI低于未使用的图像;使用O-MAR的图像金属伪影评分高于未使用,诊断信息评分未使用O-MAR高于使用;对不同迭代等级,无论是否使用O-MAR,图像伪影和诊断信息评分均无差异。结论:建议联合使用O-MAR技术及中间迭代等级iDose^(4)-3重建骨算法图像;软组织算法图像重建时不推荐使用迭代算法,建议同时重建使用和不使用O-MAR的图像以便配合观察。Objective:Exploring the effect of metal artifact reduction(O-MAR) technology combined with iterative algorithms on the computed tomography(CT) image quality of patients after lumbar spine internal fixation surgery,to provide an accurate basis for postoperative effect evaluation.Methods:CT images were collected from 20 patients who underwent lumbar spine internal fixation surgery.Using O-MAR,filtered back projection(FBP),and iDose^(4) algorithms,bone(iDose^(4)-1 ~ 7 levels) and soft tissue images(iDose^(4)-1 ~ 6 levels) were reconstructed.Screws were displayed the best in transverse and sagittal bone reconstructed images.The screw area(center plane) of the transverse soft tissue images of the intervertebral disc was also reconstructed.Noise levels in standard deviation(SD) of bone and muscle were measured,and the artifact index(AI) was calculated.Two radiologists separately rated the metal artifact suppression and diagnostic information in the bone and soft tissue images.The subjective and objective evaluation indicators of the two groups were compared,conducting multiple comparisons between groups.Statistical analyses were further performed on subjective and objective evaluation indicators,including O-MAR comparisons and/or multiple comparisons between groups with different levels of iDose^(4).Results:In the bone images,the SD and AI of images using O-MAR were significantly lower than those without O-MAR,and the AI values of iDose^(4) images at different levels gradually decreased as the dose level increased.The subjective score of metal artifacts in O-MAR images significantly improved,and the score of iDose^(4)-5 ~ 7 was higher than those of filtered back projection(FBP) and iDose^(4)-1 ~ 2.With O-MAR,the diagnostic information score significantly improved.The score of iDose^(4)-2 ~ 4 was higher than that of FBP and other iterative levels,with iDose^(4)-3 being the best.In soft tissue images,the SD and AI of images using O-MAR were lower than those without O-MAR.The metal artifact score of images using O-MAR was

关 键 词：迭代算法 图像质量 O-MAR 主观评价 伪影指数 

分 类 号：O242[理学—计算数学] R814[理学—数学]