320排CT使用迭代技术运用于全脑灌注与四维减影摄影  

Lower-Dose Whole Brain Perfusion and 4D Dynamic DSA Applications Utilized by 320-Section Area Detector CT( 320-ADCT) with State-of-the-art Adaptive Iterative Reconstruction Algorithm

作　　者：刘永锜 梁家豪 陈昭宏 叶志盛 钟正国 杨光明 

机构地区：[1]中国台湾中国长庚医疗财团法人林口长庚纪念医院影像诊疗科部 [2]厦门长庚医院放射科 [3]中国台湾阳明大学生物医学影像暨放射科学系

出　　处：《中国辐射卫生》2015年第5期561-565,共5页Chinese Journal of Radiological Health

摘　　要：目的使用较低剂量脑血流灌注扫描条件,再搭配顺适性低剂量迭代重建技术噪声抑制算法来评估4D脑血管疾病与脑血流灌注检查。利用高阶320排CT来诊断脑血管初期病变以期增加影像诊断精确度并有效降低病人接受辐射剂量之风险。方法利用0.75 sec/r的转速、80~120 k V的管电压、120~280 m A的管电流、创新的迭代重建去除噪声技术来执行13次容积扫描(每次16 cm涵盖范围)的全脑灌注检查。在前25 s与后35 s设计分别执行每2 s与每7 s之间歇式低剂量辐射曝射以顺利捕捉动脉相与静脉相影像序列;而第一次与最后一次的辐射曝露则执行高质量的药前与药后的影像扫描。结果此系统不但可提供优异的脑血流灌注分析结果,而且也可获取四维的数字减影血管摄影结果。不但能有效观察动静脉畸形与动脉瘤变化,且能让病人免除遭受侵入性检查(传统血管摄影检查)的痛苦与风险。结论根据本研究结果,未来此低剂量的脑部检查非常有潜力成为常规自费健检的项目之一,以早期发现脑部病变。Objective To evaluate 4-dimensional( 4D) cerebral vessels and whole brain perfusion with lower-dose imaging protocol utilized by 320-row area detector CT( 320-ADCT) and adaptive iterative reconstruction algorithm for distinguishing brain diseases more accurately and reducing more radiation risk. Methods 13 volume scans with the rotation speed of 0. 75 sec / r,tube voltage of 80 ~ 120 k V,tube current of 120 ~ 280 m A,innovative iterative reconstruction algorithm for de-noising,and 16 cm z-axis scan coverage were executed in this study. 2-second and 7-second lower-dose intermittent exposure shots were performed to catch arterial and venous flow in the first 25 seconds and in the other 35 seconds,respectively; while high quality protocols performed in the first and last shots were designed for pre-and post-contrast enhancement.Results It revealed that the system could provide not only excellent brain perfusion analysis but also 4D DSA application with AVM and aneurysm avoiding from the suffering to patients and the risk of invasive conventional angiography. Conclusion It has a good potential to add the low-dose brain perfusion examination to one of the routine checkup items for early finding of brain diseases in the near future.

关 键 词：脑血流灌注 数字减影血管摄影 容积式探测器X射线计算器体层扫描仪 多排探测器X射线计算器体层扫描仪 顺适性低剂量容积双空间迭代重建技术 

分 类 号：R816.1[医药卫生—放射医学]