双源CT低管电压结合迭代重建评估冠状动脉支架成像的可行性

发布时间：2018-08-28 20:08

【摘要】：目的探讨第二代双源CT低管电压(100 k V)扫描联合基于原始数据的迭代重建(SAFIRE)在冠状动脉支架成像中的可行性。资料与方法 156例患者冠状动脉支架植入术后行CT冠状动脉成像,其中86例采用100 k V结合SAFIRE重建,70例采用120 k V结合滤波反投影重建,比较两组图像主动脉根部、支架内、支架近端冠状动脉的平均CT值、图像噪声、信噪比(SNR)、支架内CT值净增比(SAIR)、图像质量主观评分、支架显示情况、辐射剂量等。结果 100 k V组主动脉根部、支架内、支架近端冠状动脉平均CT值高于120 k V组(t=2.75、11.77、3.19,P0.05),图像噪声及SAIR低于120 k V组(t=-2.53、-9.51,P0.05);100 k V组与120 k V组主动脉根部、支架内、支架近端冠状动脉SNR差异无统计学意义(t=-1.34、-0.95、-1.67,P0.05)。100 k V、SAFIRE重建图像质量主观评分与120 k V、滤波反投影重建差异无统计学意义(t=-0.203,P0.05);两组共显示243个支架,其中右冠状动脉67个,左前降支123个,回旋支36个,其他分支17个;支架长度3.8~98.7 mm,平均(27.5±16.4)mm。100 k V组容积CT剂量指数、剂量长度乘积、有效剂量均低于120 k V组(t=-11.03、-9.41、-9.41,P0.05),采用100 k V扫描时有效剂量降低约51.5%。结论第二代双源CT低管电压(100 k V)联合SAFIRE重建技术评价冠状动脉支架不会增加图像噪声及支架射束硬化伪影,能满足诊断要求,并显著降低辐射剂量。
[Abstract]:Objective to investigate the feasibility of the second generation dual-source CT low tube voltage (100 k V) scan) combined with iterative reconstruction of (SAFIRE) based on original data in coronary stenting. Materials and methods CT coronary angiography was performed in 156 patients after coronary stenting. Among them, 86 patients underwent 100kV and SAFIRE reconstruction and 70 patients underwent 120kV combined with filtered back-projection reconstruction. The aortic root and stent were compared between the two groups. The mean CT value, image noise, SNR (SNR), CT value in the proximal coronary artery were higher than those in (SAIR), image quality subjective score, stent display, radiation dose and so on. Results the mean CT value of aortic root, stent and proximal coronary artery in 100kV group was higher than that in 120kV group (t = 2.75 卤11.77.3.19g P 0.05), image noise and SAIR were lower than 120kV group (t ~ (-2.53) ~ (-9.51) P _ (0.05), the aortic root of 100kV group and 120kV group were found in the stent. There was no significant difference in SNR of proximal coronary artery between the two groups (t _ (1.34) ~ (-0.95) ~ (-1.67). The subjective score of image quality and 120kV of SAFIRE were not significantly different (t ~ (-0.203) P 0.05), there were 243 stents in the two groups, including 67 right coronary arteries, 123 left anterior descending branches, and no significant difference in image quality between the two groups (t ~ (-1) ~ (-1.34) ~ (-0.95) ~ (-1) ~ (-1) ~ (-1) ~ (-1). There were 36 circumflex branches and 17 other branches, and the mean volume CT dose index, dose length product and effective dose were lower than 120kV group (t ~ (-11.03) -9.41 ~ 9.41 ~ (-1) P _ 0.05), and the effective dose was decreased by 51.5% in 100kV scanning group (mean (27.5 卤16.4) mm.100 路kg ~ (-1) KV), and the effective dose was lower than that in 120kV group (t ~ (-1) -11.03 ~ (-9.41) -9.41 ~ (-1) (P0.05). Conclusion the second generation dual-source CT low tube voltage (100 k V) combined with SAFIRE reconstruction) can not increase image noise and beam hardening artifacts of coronary stents and can meet the diagnostic requirements and significantly reduce the radiation dose.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【分类号】：R816.2

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