能谱CT单能量结合ASiR技术对腹部静脉成像质量的优化研究
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摘要
目的:比较不同水平的自适应迭代重建算法(ASiR)在腹部静脉血管最佳单能量成像中的图像质量,优化腹部静脉血管的成像参数。方法:回顾性分析上腹部能谱增强扫描检查患者30例。通过后处理工作站测量出最佳单能量值,分别用30%ASiR、40%ASiR及50%ASiR算法进行重建,分析比较三组图像及混合能量组图像中各静脉的CT值、图像噪声SDn、CNR及SNR。由放射科两名资深诊断医师采用双盲法对四组数据进行主观评估并记录评分。结果:混合能量组与其他三组在CT值、SDn、CNR及SNR均具有统计学差异(P <0.01)。30%ASiR组、40%ASiR组及50%ASiR组图像在CT值方面均无统计学差异(P> 0.05)。在门静脉主干、肠系膜上静脉及脾静脉30%ASiR组与50%ASiR组之间的SDn、CNR、SNR均有统计学差异(P <0.05),30%ASiR组与40%ASiR组,40%ASiR组与50%ASiR组之间的SDn、CNR、SNR均无统计学差异(P> 0.05);在下腔静脉主干、左肾静脉、右肾静脉、肝左静脉、肝中静脉和肝右静脉30%ASiR组与50%ASiR组之间的SDn、CNR均有统计学差异(P <0.05),30%ASiR组与40%ASiR组,40%ASiR组与50%ASiR组之间的SDn、CNR均无统计学差异(P> 0.05),三组图像之间的SNR均有统计学差异(P <0.05)。结论:最佳单能量(65 keV)+40%ASiR在腹部静脉血管的成像质量较其他三组有所提高,可以在临床腹部静脉血管成像方面广泛应用。
Objective: To compare the imaging quality of different levels of the adaptive algorithm of iterative reconstruction(ASiR) in abdominal venous optimal single energy image to optimize imaging parameters of abdominal vein. Materials and Methods: Retrospective analysis was performed on 30 patients who underwent CT upper abdomen enhancement scan. All the subjects were scaned with spectral model and optimal single energy images were calculated using postprocessing workstation, and then reconstructed with ASiR 30%, ASiR 40% and ASiR 50% algorithm respectively. Finally, three group images of different ASiR levels were acquired. The CT value, image noise, contrast noise ratio(CNR) and signal noise ratio(SNR) of all abdominal vein were compared among the images of the three single energy groups and one mixed energy group by using single factor analysis of variance(ANOVA). The data of four groups were subjectively evaluated by two professional diagnostic physicians using double blind method. Results: The original spectral CT data were processed to acquire the 65 ke V images, which were reconstructed with 30% ASiR, 40% ASiR and 50% ASiR, respectively. Together with the mixed energy group, finally four groups were obtained. There were statictically significant differences of CT value, image noise, CNR and SNR between the mixed energy group and the other three single energy groups(P < 0.01). There was no significant difference in CT value among 30% ASiR group, 40% ASiR group and 50% ASiR group(P > 0.05). For the portal vein trunk, mesenteric vein and splenic vein, there were significant differences of image noise, CNR and SNR between the 30% ASiR group and the 50% ASiR group(P < 0.05), while no differences of that parameters between the 30% ASiR group and the 40% ASiR group, as well as 40% ASiR group and the 50% ASiR group(P > 0.05); For the inferior vena cava trunk, the left renal vein, the right renal vein, the left hepatic vein, the middle hepatic vein and the right hepatic vein, there were significant differences of image noise and CNR between the 30% ASiR group and the 50% ASiR group(P < 0.05), while no differences of that parameters between the 30% ASiR group and the 40% ASiR group, as well as 40% ASiR group and the 50% ASiR group(P > 0.05); There were significant differences of SNR among the three groups(P < 0.05). Conclusion: For the abdominal veins, the imaging quality of the optimal single energy(65 ke V) + 40% ASiR is better than that of the 65 ke V + 30% ASiR, 65 ke V + 50% ASiR and the mixed energy group, which can be widely used in clinical abdominal venous angiography.
Objective: To compare the imaging quality of different levels of the adaptive algorithm of iterative reconstruction(ASiR) in abdominal venous optimal single energy image to optimize imaging parameters of abdominal vein. Materials and Methods: Retrospective analysis was performed on 30 patients who underwent CT upper abdomen enhancement scan. All the subjects were scaned with spectral model and optimal single energy images were calculated using postprocessing workstation, and then reconstructed with ASiR 30%, ASiR 40% and ASiR 50% algorithm respectively. Finally, three group images of different ASiR levels were acquired. The CT value, image noise, contrast noise ratio(CNR) and signal noise ratio(SNR) of all abdominal vein were compared among the images of the three single energy groups and one mixed energy group by using single factor analysis of variance(ANOVA). The data of four groups were subjectively evaluated by two professional diagnostic physicians using double blind method. Results: The original spectral CT data were processed to acquire the 65 ke V images, which were reconstructed with 30% ASiR, 40% ASiR and 50% ASiR, respectively. Together with the mixed energy group, finally four groups were obtained. There were statictically significant differences of CT value, image noise, CNR and SNR between the mixed energy group and the other three single energy groups(P < 0.01). There was no significant difference in CT value among 30% ASiR group, 40% ASiR group and 50% ASiR group(P > 0.05). For the portal vein trunk, mesenteric vein and splenic vein, there were significant differences of image noise, CNR and SNR between the 30% ASiR group and the 50% ASiR group(P < 0.05), while no differences of that parameters between the 30% ASiR group and the 40% ASiR group, as well as 40% ASiR group and the 50% ASiR group(P > 0.05); For the inferior vena cava trunk, the left renal vein, the right renal vein, the left hepatic vein, the middle hepatic vein and the right hepatic vein, there were significant differences of image noise and CNR between the 30% ASiR group and the 50% ASiR group(P < 0.05), while no differences of that parameters between the 30% ASiR group and the 40% ASiR group, as well as 40% ASiR group and the 50% ASiR group(P > 0.05); There were significant differences of SNR among the three groups(P < 0.05). Conclusion: For the abdominal veins, the imaging quality of the optimal single energy(65 ke V) + 40% ASiR is better than that of the 65 ke V + 30% ASiR, 65 ke V + 50% ASiR and the mixed energy group, which can be widely used in clinical abdominal venous angiography.
引文
[1]赵晶.门静脉的能谱CT成像[D].北京:北京协和医学院, 2015.ZHAO J. Spectral CT imaging of the portal vein[D]. Beijing:Peking Union Medical College, 2015.(in Chinese).
[2]霍福涛,李需. CT对比剂肾病的认识和预防[J].中国中西医结合影像学杂志, 2015, 13(4):470-473.HUO F T, LI X. Cognition and prevention of CT contrast agent nephropathy[J]. Chinese Imaging Journal of Integrated Traditional and Western Medicine,2015, 13(4):470-473.(in Chinese).
[3]ICHIKAWA T, MOTOSUGI U, MORISAKA H, et al. Optimal iodine dose for 3-dimensional multidetector-row CT angiography of the liver[J]. European Journal of Radiology, 2012, 81(9).
[4]夏巍,吴晶涛,尹肖睿,等.低管电压法与低管电流法在降低多层螺旋CT下肢静脉成像辐射剂量中的对比研究[J].中华放射学杂志, 2013, 47(4):368-370.XIA W, WU J T, YIN X R, et al. Comparative study of low-tube voltage method and low-tube current method in reducing radiation dose of lower extremity spiral CT in lower extremity vein imaging[J]. Chinese Journal of Radiology, 2013, 47(4):368-370.(in Chinese).
[5]BEHRENDT F F, MAHNKEN A, KEIL S, et al. Contrast enhancement in multi-detector-row computed tomography(MDCT)of the abdomen:Intraindividual comparison of contrast media containing300 mg versus 370mg iodine per ml[J]. European Radiology, 2008, 18(6):1199-1205.
[6]LI J, UDAYASANKAR U K, TANG X, et al. An optimal contrast dose indicator for the determination ofhepaticenhancementinabdominalmulti-detectorcomputedtomography:Comparisonof patient attenuation indicator with total body weight and body mass index[J]. Journal of Computer Assisted Tomography, 2010, 34(6):874-878.
[7]陈盈,米玉成,曾春光,等. HDCT能谱技术提高肝脏门静脉血管成像质量的可行性研究[J].临床放射学杂志, 2012, 31(1):61-64.CHEN Y, MI Y C, ZENG C G, et al. Nvestigation of image quality of portal venography using spectral CT[J]. Journal of Clinical Radiology, 2012, 31(1):61-64.(in Chinese).
[8]曹锋,王传彬,董江宁,等.能谱CT最佳单能量技术优化甲状腺肿瘤供血动脉图像质量的研究[J].医学影像学杂志, 2017, 27(8):1443-1446.CAO F, WANG C B, DONG J N, et al. A preliminary study of the value of the optimal monochromatic technology of gemstone spectral imaging in displaying the supply artery of thyroid tumors[J].Journal of Medical Imaging, 2017, 27(8):1443-1446.(in Chinese).
[9]刘筱霜,周孟,肖艳,等.能谱CT单能量融合技术优化子宫动脉CTA图像质量研究[J].临床放射学杂志, 2016, 35(4):638-642.LIU X S, ZHOU M, XIAO Y, et al. Image fusion of monochromatic technique on CTA imaging quality of the uterine artery with spectral CT[J]. Journal of Clinical Radiology, 2016,35(4):638-642.(in Chinese).
[10]殷小平,刘笑非,黄桦,等.能谱CT最佳单能量技术优化腹腔干动脉成像质量的研究[J].临床放射学杂志, 2015, 34(5):808-811.YIN X P, LIU X F, HUANG H, et al. Optimization of celiac artery image quality with best monochromatic spectral CT technology[J]. Journal of Clinical Radiology, 2015, 34(5):808-811.(in Chinese).
[11]夏巍,宋旭升,尹肖睿,等.宝石CT能谱最佳单能量图像在下肢动脉造影中的应用[J].中国医学影像学杂志, 2014(11):842-845.XIA W, SONG XS, YIN X R, et al. Gemstone spectral CT optimal single energy imaging in lower extremity angiography[J]. Chinese Journal of Medical Imaging, 2014(11):842-845.(in Chinese).
[12]BEISTER M, KOLDITZ D, KALENDER W A. Iterative reconstruction methods in X-ray CT[J]. Physica Medica:Pm:An International Journal Devoted to the Applications of Physics to Medicine and Biology:Official Journal of the Italian Association of Biomedical Physics(AIFB), 2012,28(2):94-108.
[13] VARDHANABHUTIV,RIORDAN RD, MITCHELL GR,et al. Imagecomparative assessment using iterativereconstructions:Clinicalcomparisonoflow-doseabdominal/pelviccomputed tomographybetweenadaptivestatistical,model-basediterativereconstructionsand traditional filtered back projection in 65 patients[J]. Investigative Radiology, 2014,49(4):209-216.
[14]TAKAHASHI H, OKADA M, HYODO T, et al. Can low-dose CT with iterative reconstruction reduce both the radiation dose and the amount of iodine contrast medium in a dynamic CT study of the liver?[J]. European Journal of Radiology, 2014, 83(4):684-691.
[15]GERVAISE A, OSEMONT B, LECOCQ S, et al. CT image quality improvement using Adaptive Iterative Dose Reduction with wide-volume acquisition on 320-detector CT[J]. International Journal of Medical Radiology, 2012, 22(2):295-301.
[16]陈晓,曹国全,潘勇,等.能谱CT单能量联合迭代重建对图像质量的影响[J].温州医科大学学报,2016, 46(9):633-637.CHEN X, CAO G Q, PAN Y, et al. Influence of spectral CT monochromatic imaging in combination with iteractive reconstruction algorithm on image quality[J]. Journal of Wenzhou Medical University, 2016, 46(9):633-637.(in Chinese).
[17]石清磊,赵红梅,张玲,等.自适应统计迭代重建算法对腹部CT扫描中图像质量和辐射剂量影响的模体研究[J].中华放射学杂志, 2013, 47(4):326-329.SHI Q L, ZHAO H M, ZHANG L, et al. Evaluation of dose reduction and image quality in abdominal CT using adaptive statistical iterative reconstruction in a phantom study[J]. Chinese Journal of Radiology, 2013, 47(4):326-329.(in Chinese).
[18]袁灼彬,郑晓林,邹玉坚,等.迭代重建技术在CT腹部低剂量扫描应用的可行性研究[J].临床放射学杂志, 2016, 35(2):288-293.YUAN Z B, ZHENG X L, ZOU Y J, et al. An application study on the feasibility of abdominal low-dose CT with hybrid iterative reconstruction[J]. Journal of Clinical Radiology, 2016,35(2):288-293.(in Chinese).
[2]霍福涛,李需. CT对比剂肾病的认识和预防[J].中国中西医结合影像学杂志, 2015, 13(4):470-473.HUO F T, LI X. Cognition and prevention of CT contrast agent nephropathy[J]. Chinese Imaging Journal of Integrated Traditional and Western Medicine,2015, 13(4):470-473.(in Chinese).
[3]ICHIKAWA T, MOTOSUGI U, MORISAKA H, et al. Optimal iodine dose for 3-dimensional multidetector-row CT angiography of the liver[J]. European Journal of Radiology, 2012, 81(9).
[4]夏巍,吴晶涛,尹肖睿,等.低管电压法与低管电流法在降低多层螺旋CT下肢静脉成像辐射剂量中的对比研究[J].中华放射学杂志, 2013, 47(4):368-370.XIA W, WU J T, YIN X R, et al. Comparative study of low-tube voltage method and low-tube current method in reducing radiation dose of lower extremity spiral CT in lower extremity vein imaging[J]. Chinese Journal of Radiology, 2013, 47(4):368-370.(in Chinese).
[5]BEHRENDT F F, MAHNKEN A, KEIL S, et al. Contrast enhancement in multi-detector-row computed tomography(MDCT)of the abdomen:Intraindividual comparison of contrast media containing300 mg versus 370mg iodine per ml[J]. European Radiology, 2008, 18(6):1199-1205.
[6]LI J, UDAYASANKAR U K, TANG X, et al. An optimal contrast dose indicator for the determination ofhepaticenhancementinabdominalmulti-detectorcomputedtomography:Comparisonof patient attenuation indicator with total body weight and body mass index[J]. Journal of Computer Assisted Tomography, 2010, 34(6):874-878.
[7]陈盈,米玉成,曾春光,等. HDCT能谱技术提高肝脏门静脉血管成像质量的可行性研究[J].临床放射学杂志, 2012, 31(1):61-64.CHEN Y, MI Y C, ZENG C G, et al. Nvestigation of image quality of portal venography using spectral CT[J]. Journal of Clinical Radiology, 2012, 31(1):61-64.(in Chinese).
[8]曹锋,王传彬,董江宁,等.能谱CT最佳单能量技术优化甲状腺肿瘤供血动脉图像质量的研究[J].医学影像学杂志, 2017, 27(8):1443-1446.CAO F, WANG C B, DONG J N, et al. A preliminary study of the value of the optimal monochromatic technology of gemstone spectral imaging in displaying the supply artery of thyroid tumors[J].Journal of Medical Imaging, 2017, 27(8):1443-1446.(in Chinese).
[9]刘筱霜,周孟,肖艳,等.能谱CT单能量融合技术优化子宫动脉CTA图像质量研究[J].临床放射学杂志, 2016, 35(4):638-642.LIU X S, ZHOU M, XIAO Y, et al. Image fusion of monochromatic technique on CTA imaging quality of the uterine artery with spectral CT[J]. Journal of Clinical Radiology, 2016,35(4):638-642.(in Chinese).
[10]殷小平,刘笑非,黄桦,等.能谱CT最佳单能量技术优化腹腔干动脉成像质量的研究[J].临床放射学杂志, 2015, 34(5):808-811.YIN X P, LIU X F, HUANG H, et al. Optimization of celiac artery image quality with best monochromatic spectral CT technology[J]. Journal of Clinical Radiology, 2015, 34(5):808-811.(in Chinese).
[11]夏巍,宋旭升,尹肖睿,等.宝石CT能谱最佳单能量图像在下肢动脉造影中的应用[J].中国医学影像学杂志, 2014(11):842-845.XIA W, SONG XS, YIN X R, et al. Gemstone spectral CT optimal single energy imaging in lower extremity angiography[J]. Chinese Journal of Medical Imaging, 2014(11):842-845.(in Chinese).
[12]BEISTER M, KOLDITZ D, KALENDER W A. Iterative reconstruction methods in X-ray CT[J]. Physica Medica:Pm:An International Journal Devoted to the Applications of Physics to Medicine and Biology:Official Journal of the Italian Association of Biomedical Physics(AIFB), 2012,28(2):94-108.
[13] VARDHANABHUTIV,RIORDAN RD, MITCHELL GR,et al. Imagecomparative assessment using iterativereconstructions:Clinicalcomparisonoflow-doseabdominal/pelviccomputed tomographybetweenadaptivestatistical,model-basediterativereconstructionsand traditional filtered back projection in 65 patients[J]. Investigative Radiology, 2014,49(4):209-216.
[14]TAKAHASHI H, OKADA M, HYODO T, et al. Can low-dose CT with iterative reconstruction reduce both the radiation dose and the amount of iodine contrast medium in a dynamic CT study of the liver?[J]. European Journal of Radiology, 2014, 83(4):684-691.
[15]GERVAISE A, OSEMONT B, LECOCQ S, et al. CT image quality improvement using Adaptive Iterative Dose Reduction with wide-volume acquisition on 320-detector CT[J]. International Journal of Medical Radiology, 2012, 22(2):295-301.
[16]陈晓,曹国全,潘勇,等.能谱CT单能量联合迭代重建对图像质量的影响[J].温州医科大学学报,2016, 46(9):633-637.CHEN X, CAO G Q, PAN Y, et al. Influence of spectral CT monochromatic imaging in combination with iteractive reconstruction algorithm on image quality[J]. Journal of Wenzhou Medical University, 2016, 46(9):633-637.(in Chinese).
[17]石清磊,赵红梅,张玲,等.自适应统计迭代重建算法对腹部CT扫描中图像质量和辐射剂量影响的模体研究[J].中华放射学杂志, 2013, 47(4):326-329.SHI Q L, ZHAO H M, ZHANG L, et al. Evaluation of dose reduction and image quality in abdominal CT using adaptive statistical iterative reconstruction in a phantom study[J]. Chinese Journal of Radiology, 2013, 47(4):326-329.(in Chinese).
[18]袁灼彬,郑晓林,邹玉坚,等.迭代重建技术在CT腹部低剂量扫描应用的可行性研究[J].临床放射学杂志, 2016, 35(2):288-293.YUAN Z B, ZHENG X L, ZOU Y J, et al. An application study on the feasibility of abdominal low-dose CT with hybrid iterative reconstruction[J]. Journal of Clinical Radiology, 2016,35(2):288-293.(in Chinese).