不同碘浓度CT成像对冠状动脉支架评价的研究

发布时间：2018-01-19 07:31

本文关键词： 冠状动脉支架支架内再狭窄碘浓度迭代重建图像质量　出处：《心肺血管病杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的:利用心脏动态体模,评价低碘浓度CT成像对冠状动脉支架评价的可行性及可靠性。方法:利用体外心脏动态模型及带支架模拟冠状动脉12条(每条支架内分别放置阶梯状有机玻璃以模拟无狭窄及25%,50%,75%的狭窄),模拟心率58~62次/min,在管电压100 k V下,保持5种CT值(250 Hu、300 Hu、350Hu、400 Hu、及450±5 Hu)不变的情况下扫描,将图像进行迭代算法(IR)重建。比较组间图像质量(包括主观评分及支架内CT值、噪声、信噪比及对比噪声比),与真实狭窄对照,比较组间诊断显著狭窄准确性,比较支架内径显示率,比较各组碘浓度。结果:图像质量主观评分组间差异无统计学意义(P0.05)。图像质量客观指标显示:支架内CT值、信噪比、对比噪声比均差异有统计学意义(P0.05);图像噪声差异无统计学意义(P0.05),与真实狭窄比较,五组支架内显著狭窄诊断的敏感度及阴性预测值均为100%,特异度91.67%~95.83%,阳性预测值92.31%~96.00%,总符合率95.83%~97.92%,Kappa=0.91~0.95。不同碘浓度对支架内径值及内径显示率比较无明显差异。通过五种碘浓度比较,从250 Hu到450 Hu,碘浓度由8.2 mg I/m L升至14.75 mg I/m L,碘含量增加了79.88%。结论:低碘浓度成像可以保证图像质量,诊断支架内狭窄具有可靠性,同时可明显降低碘负荷,支架内径显示率不降低。
[Abstract]:Objective: to use cardiac dynamic phantom. To evaluate the feasibility and reliability of low iodine concentration CT imaging in evaluating coronary stents. Methods: 12 coronary arteries were simulated with in vitro cardiac dynamic model and stent. Step plexiglass was placed in each bracket to simulate no stenosis and 25%. At a voltage of 100 kV, 5 CT values of 250 Hu-300 Hu-350Hu were maintained at a simulated heart rate of 5862 times / min. The images were scanned with 400 Huand 450 卤5 Hu. the image was reconstructed by iterative algorithm (IRR). The image quality (including subjective score, CT value in stent, noise) was compared between the two groups. The signal-to-noise ratio (SNR) and contrast noise ratio were compared with the true stenosis. Results: there was no significant difference in subjective score of image quality between groups (P 0.05). The objective index of image quality showed CT value and SNR in stent. The difference of noise ratio was statistically significant (P 0.05). The difference of image noise was not statistically significant (P 0.05). Compared with true stenosis, the sensitivity and negative predictive value of significant stenosis in the five groups were 100%. The specificity was 91.67 and the positive predictive value was 92.31 and 96.00, and the total coincidence rate was 95.83 / 97.92%. There was no significant difference between different iodine concentrations on the internal diameter of stent and the display rate of the inner diameter. Through the comparison of five iodine concentrations, the values ranged from 250 Hu to 450 Hu. The iodine concentration increased from 8.2 mg I / mL to 14.75 mg I / mL, and the iodine content increased by 79.88. Conclusion: low iodine concentration imaging can ensure the image quality. The diagnosis of stent stenosis is reliable, at the same time, the iodine load can be significantly reduced, and the display rate of stent diameter is not reduced.
【作者单位】：北京市第六医院放射科;首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科;
【基金】：北京市优秀人才项目(2011D003034000030)
【分类号】：R816.2;R541.4
【正文快照】： 作者单位:100007北京市第六医院放射科(赵春荣);首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科(徐磊范占明杨琳陆东旭)were from 92.31%to 96.00%.The consistent rate was from 95.83%to 97.92%.Kappa=0.91~0.95.Therewas no significant difference in

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