单能量去金属伪影技术在腹主动脉瘤腔内修复术后CT血管造影复查中的应用价值  

The application value of single energy metal artifact reduction technique in computed tomography angiography examination after endovascular repair of abdominal aortic aneurysm

作　　者：蒋海蓉 王冕[2] 赖志满 谢定祥 吴嘉乐 赵静[3] 马慧 陈笑芳 Jiang Hairong;Wang Mian;Lai Zhiman;Xie Dingxiang;Wu Jiale;Zhao Jing;Ma Hui;Chen Xiaofang(Department of Radiology,Foresea Life Insurance Guangzhou General Hospital,Guangzhou 511300,Guangdong,China;Department of Vascular Surgery,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China;Department of Diagnostic Radiology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China)

机构地区：[1]前海人寿广州总医院放射科,广东广州511300 [2]中山大学附属第一医院血管外科,广东广州510080 [3]中山大学附属第一医院放射诊断科,广东广州510080

出　　处：《中国血管外科杂志(电子版)》2025年第1期33-38,45,共7页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金青年科学基金项目(82202217)。

摘　　要：目的探讨单能量去金属伪影(single energy metal artifact reduction,SEMAR)技术在腹主动脉瘤腔内修复术(endovascular aortic repair,EVAR)后CT血管造影(computed tomography angiography,CTA)复查中的应用价值。方法回顾性分析2023年3月至2024年7月中山大学附属第一医院61例(66例次)在腹主动脉瘤EVAR术后行CTA图像复查患者的临床资料。每例完成扫描患者的数据均使用混合迭代重建(hybrid iterative reconstruction,HIR)和HIR联合SEMAR算法进行容积重建并分别设为HIR组和SEMAR组,对两组进行整体图像质量主观评分,并测量两组腹主动脉瘤支架内选取主体支架段、左髂分支段及右髂分支段伪影最重的横断层面、支架外腹主动脉瘤腔内血栓取伪影最重及伪影最少的横断层面和无支架层面腹主动脉等的CT值和噪声值,计算信噪比(signal-noise ratio,SNR)、对比度噪声比(constrast-to-niose ratio,CNR)和伪影指数(artifacts index,AI),对比两组的图像评分效果。结果SEMAR组的整体图像质量主观评分优于HIR组,差异有统计学意义(U=436.00,P<0.001)。相对于HIR组,SEMAR组主体支架内最大伪影、左髂支架内最大伪影、右髂支架内最大伪影及支架外血栓最大伪影的SNR和CNR较大,AI较小,差异均有统计学意义(P<0.05);两组间支架外血栓最小伪影、支架内最小伪影及无支架腹主动脉段SNR、CNR、AI比较差异均无统计学意义(P>0.05)。结论相比HIR,SEMAR技术能减少金属支架产生的伪影,清晰显示周边器官、支架内外血管、瘤体血栓等情况,有助于EVAR术后内漏、栓塞情况等事件的评估。Objective To explore the application value of single energy metal artifact reduction(SEMAR)in computed tomography angiography(CTA)reexamination after endovascular aortic repair(EVAR)for abdominal aortic aneurysm.Methods The clinical data of 61 patients who underwent CTA image reexamination after EVAR(66 cases)for abdominal aortic aneurysm in the First Affiliated Hospital of Sun Yat-sen University from March 2023 to July 2024 and were analyzed retrospectively.The imaging data of each patient was reconstructed by hybrid iterative reconstruction(HIR)and SEMSR techniques,which were designated as the HIR group and the SEMAR group.The subjective score of the overall image quality of HIR group and SEMAR group was evaluated.The CT values and standard deviations of the abdominal aorta,the most artifact in the stent,the most artifact in the abdominal aortic aneurysm,the transverse section with the heaviest artifacts in the main body segment,the left iliac segment and the right iliac segment in the abdominal aortic aneurysm,the transverse section with the heaviest artifacts in the intraluminal embolus of the external abdominal aortic aneurysm,and the transverse section with the least artifacts were measured in the both groups,and the constrast-to-niose ratio(CNR),signal-noise ratio(SNR)and artifacts index(AI)were also calculated.The image quality scores of two groups were compared.Results The subjective score of overall image quality in SEMAR group was better than that in HIR group,and the difference was statistically significant(U=436.00,P<0.001).Compared with the HIR group,the SEMAR group had higher SNR and CNR and lower AI for the maximum artifacts within the main stent,left iliac stent,right iliac stent,and the maximum artifact in the thrombus outside the stent,all with statistically significant differences(P<0.05).There were no statistically significant differences in SNR,CNR and AI between the two groups for the minimum artifact in the thrombus outside the stent,the least artifact within the stent,and the abdominal ao

关 键 词：腹主动脉瘤 CT血管造影 去金属伪影 迭代重建 

分 类 号：R543.1[医药卫生—心血管疾病]