双层探测器光谱CT单能量成像联合去金属伪影算法在TIPS术后随访的应用价值  

The Application Value of Dual-Layer Detector Spectral CT Single-Energy Imaging Combined with Metal Artifact Reduction Algorithm in the Follow-up after TIPS Procedure

作　　者：杨美英 胡继红[1] 赵卫[1] 王滔[1] 马帅 刘芳志 YANG Meiying;HU Jihong;ZHAO Wei(Department of Medical Imaging,The First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,P.R.China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032

出　　处：《临床放射学杂志》2025年第4期723-729,共7页Journal of Clinical Radiology

摘　　要：目的探讨双层探测器光谱CT单能量成像联合去属伪影算法在TIPS术后随访的应用价值。方法搜集37例经颈静脉肝内门体分流术(TIPS)术后行CT复查的患者,扫描图像重组为混合能量图(PI)、虚拟单能量成像(VMI)、去金属伪影算法(MAR)及VMI+MAR图像,选定门静脉期PI图像弹簧圈金属伪影最重层面及相邻层面勾画感兴趣区(ROI),比较四组图像的CT值、标准差(SD),伪影指数(AI)、对比噪声比(CNR)、伪影去除率(BAR)及主观评分,对所得结果进行统计分析,以P<0.05为差异有统计学意义。结果与PI组相比,80~200 keV、MAR组及VMI+MAR组的SD和AI值均显著降低(P<0.05)。低能级VMI图像(40~60 keV)的CNR值高于PI图像,MAR、高能级VMI(100~200 keV)及VMI+MAR图像(80~200 keV)的CNR值低于PI图像(P均<0.05)。VMI组、VMI+MAR组的BAR值随着能级的递增而增加,且VMI+MAR组的BAR最高。在相同能量级的VMI与VMI+MAR图像组中,VMI+MAR组的SD、AI及CNR值均低于VMI组(P均<0.001)。主观评价方面,80~140 keV、MAR组及VMI+MAR组的评分均高于PI图像组(P均<0.05),VMI+MAR组的主观评分最高。结论双层探测器光谱的CT VMI、MAR及VMI+MAR三种方式均能一定程度减少TIPS术后金属伪影,其中VMI联合MAR去除金属伪影效果最好。Objective To explore the application value of dual-layer detector spectral CT single-energy imaging combined with metal artifact reduction algorithm in the follow-up after TIPS procedure.Methods We collected data from 37 patients who underwent CT re-examination after TIPS procedure.The scanning images were reconstructed into four types of images:polychromatic images(PI),virtual monochromatic images(VMI),MAR images,and VMI+MAR images.Regions of interest(ROIs)were drawn on the most severe metal artifacts of the spring coil in the portal phase PI images and adjacent layers.The CT values,standard deviations(SD),artifact index(AI),contrast-to-noise ratio(CNR),artifact removal rate(BAR),and subjective scores of the four groups of images were compared.The results were statistically analyzed with a significance level of P<0.05.Results Compared with the PI group,the SD and AI values of the 80-200 keV,MAR,and VMI+MAR groups were significantly reduced(P<0.05).The CNR values of the low-energy VMI images(40-60 keV)were higher than those of the PI images,while the CNR values of the MAR,high-energy VMI(100-200 keV),and VMI+MAR images(80-200 keV)were lower than those of the PI images(P<0.05).The BAR values of the VMI and VMI+MAR groups increased with the increase of energy levels,and the BAR of the VMI+MAR group was the highest.In the same energy level VMI and VMI+MAR image groups,the SD,AI,and CNR values of the VMI+MAR group were all lower than those of the VMI group(P<0.001).In terms of subjective evaluation,the scores of the 80-140 keV,MAR,and VMI+MAR groups were all higher than those of the PI images(P<0.05),with the VMI+MAR group having the highest subjective score.Conclusion Dual-layer detector spectral CT with Volumetric Mixed Energy Imaging(VMI),Metal Artifact Reduction(MAR),and VMI combined with MAR can all reduce metal artifacts to some extent after the TIPS procedure,among which the combination of VMI and MAR shows the best effect in removing metal artifacts.

关 键 词：双层探测器光谱CT 单能量成像 经颈静脉肝内门体分流术 去金属伪影算法 弹簧圈 

分 类 号：F27[经济管理—企业管理]