256层螺旋CT O-MAR技术对髋关节置换术后伪影减除效果研究

发布时间：2018-05-29 21:37

本文选题：髋关节置换 + 去金属伪影技术　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:评估256层螺旋CT金属伪影减除技术(O-MAR,Orthopedic Metal Artifact Reduction)对髋关节置换术后患者所获的CT图像中金属伪影减除的效果,以期达到不增加患者辐射剂量的前提下获得良好图像质量的目的,保证髋关节置换术后影像学评估有效进行。材料和方法:此项研究共包括40例接受全髋关节置换术的成年患者(男女比例21:19)。所有患者均接受飞利浦256 i CT检查,CT扫描均采用相同的技术参数。研究分组设置如下:用常规扫描方案获得的原始数据作为非O-MAR组,经O-MAR重建处理后的数据作为O-MAR组。对图像质量的评价通过客观评价和主观评价两种方式进行。客观评价通过对近端伪影最大层面和远端伪影最小层面减金属伪影有效程度进行量化来评估,即通过测量并比较客观图像噪声(Objective Image Noise,OIN)来进行评估。主观评价通过双盲独立的两名阅片者在CT轴位图像分别对金属伪影、图像清晰度、结构自然逼真度及诊断信心评分,记录并进行统计学分析。结果:客观评价,近端伪影最大层面,对比非O-MAR组,O-MAR组显示更低的OIN值(59.90±21.51和81.12±26.00,t=17.17,P=0.00)。远端伪影最小层面,两组的OIN值在数值上非常接近(35.40±0.97和35.37±0.96,t=1.94,P=0.06)。主观评价,O-MAR组图像金属伪影明显减少,图像清晰度、结构自然逼真度及诊断信心均有提高。两位医师均在O-MAR组辨认具体解剖结构时有较高的诊断信心。金属伪影范围评分:4.00(1)和2.00(1),Z=-5.90,P=0.00;图像清晰度评分:3.00(1)和2.00(1),Z=-5.47,P=0.00。结构自然度评分:3.00(1)和2.00(1),Z=-5.62,P=0.00,诊断信心4.00(1)和2.50(1),Z=-5.96,P=0.00。但是有9例患者中出现O-MAR相关新伪影。结论:应用O-MAR技术能减少髋关节假体周围的金属伪影,减低图像噪声,获得更好的图像质量。同时O-MAR技术增强了观察者对髋关节置换假体附近解剖结构的能力和诊断信心,从而提高对存在金属伪影患者影像诊断的可靠性。
[Abstract]:Objective: to evaluate the effect of metal artifact subtraction technique of 256-slice spiral CT in patients with hip arthroplasty by orthopedic Metal Artifact Reduction). The aim is to obtain good image quality without increasing the radiation dose, and to ensure the effective evaluation of hip arthroplasty. Materials and methods: the study included 40 adult patients undergoing total hip replacement (21: 19% male to female). All patients underwent Philips 256 i CT scan with the same technical parameters. The study group is set up as follows: the original data obtained by the conventional scanning scheme is used as a non-O-MAR group, and the data after O-MAR reconstruction is taken as a O-MAR group. The evaluation of image quality is carried out by objective evaluation and subjective evaluation. Objective evaluation is evaluated by quantifying the maximum level of proximal artifact and the minimum level of distal artifact to subtract metal artifact, that is, by measuring and comparing objective image noise with object Image NoiseOINs. Subjective evaluation of metal artifacts, image sharpness, natural fidelity of structure and diagnostic confidence score were recorded and statistically analyzed by two double-blind independent film readers in CT axial images. Results: objective evaluation, the maximum level of proximal artifact, showed a lower OIN value of 59.90 卤21.51 and 81.12 卤26.00 t ~ (17.17) P ~ (0.000) than that of non-O-MAR group. At the minimum level of distal artifact, the OIN values of the two groups were very close to the values of 35.40 卤0.97 and 35.37 卤0.96, respectively. In the subjective evaluation group, the metal artifact was decreased, the image definition, the natural fidelity of the structure and the diagnostic confidence were improved. Both physicians had high diagnostic confidence in identifying specific anatomical structures in the O-MAR group. Metal artifact range score of: 4.00 / 1) and 2.00 / 1 / 1 / 1 / 2 / 0 / 0 / 1 / 1 / 1 / 2: 3.00 / 1) and 2.00 / 1 / 1) and 2.00 / 1 / 1 / 1 / 1 / 2 / 0 / 1 / 2 / 00 / 1 / 2 / 00 / 1 / 1 / 2. 00 / 1 / 1 / 2. Structural naturalness score: 3. 00 1) and 2. 00 0. 1 0. 0. 0. 0. 0. 0. 0 and 2. 00%-5. 62% P0. 000. Diagnostic confidence 4. 00. 1) and 2. 50? 1? -5.96? P0. 00. However, new artifacts associated with O-MAR were found in 9 patients. Conclusion: the application of O-MAR technique can reduce the metal artifacts around hip prosthesis, reduce image noise and obtain better image quality. At the same time, O-MAR technique enhanced the ability and diagnostic confidence of the observer to the anatomical structure near the hip replacement prosthesis, thus improving the reliability of the imaging diagnosis of the patients with metal artifact.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4;R816.8

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