“三低”技术联合人工智能迭代重建算法在主动脉CT血管成像中的临床应用

游永春; 李万江; 刘洪川; 钟思华; 李真林

doi:10.12182/20220760105

“三低”技术联合人工智能迭代重建算法在主动脉CT血管成像中的临床应用

Clinical Application of "Three-Low" Technique Combined with Artificial Intelligence Iterative Reconstruction Algorithm in Aortic CT Angiography

摘要

摘要:
目的探讨“三低”（低辐射剂量、低对比剂用量及低对比剂流速）技术联合人工智能迭代算法（artificial intelligence iterative reconstruction, AIIR）在主动脉CT血管成像中的应用价值。
方法前瞻性纳入33例主动脉CT血管造影（CT angiography, CTA）的患者，按复查时间先后分为A、B 两组。A组为对照组（100 kV, 0.8 mL/kg, 5 mL/s）；B组为“三低”组（70 kV, 0.5 mL/kg, 3 mL/s）。A组使用Karl迭代重建图像，B组分别使用Karl和AIIR重建得到B1和B2组。测量3组升主动脉、降主动脉、腹主动脉、左髂动脉及右髂动脉的CT值和SD值、计算信噪比（signal-to-noise ratio, SNR）和对比噪声比（contrast-to-noise ratio, CNR）。同时对图像质量行主观评分。记录A、B组辐射剂量参数。
结果 3组各管腔节段CT值、SD值、SNR及CNR差异均有统计学意义（P<0.001）。B2组CT值、SNR、CNR高于B1组，SD值低于B1组，差异均有统计学意义（P<0.017）。B2组与A组的CT值差异无统计学意义（P>0.017），各管腔节段的SD值、SNR和CNR均优于A组（P<0.017）。3组图像主观评分差异有统计学意义（P<0.05），A组与B2组差异无统计学意义（P>0.017）。B组辐射剂量、对比剂用量较A组分别降低84.14%、37.08%。
结论 “三低”联合AIIR算法可以获得和常规剂量扫描相当的主动脉CTA图像质量，而患者的辐射剂量、对比剂用量及对比剂流速都明显降低。

Abstract:
Objective To explore the application value of the "three-low" technique (low radiation dose, low contrast agent dosage and low contrast agent flow rate) combined with artificial intelligence iterative reconstruction (AIIR) in aortic CT angiography (CTA).
Methods A total of 33 patients who underwent aortic CTA were prospectively enrolled. Based on the time of their follow-up examinations, the imaging data were divided into Group A and Group B, with Group A being the control group (100 kV, 0.8 mL/kg, 5 mL/s) and Group B being the "three-low" technique group (70 kV, 0.5 mL/kg, 3 mL/s). In group A, the images were reconstructed by Karl iterative algorithm. Group B was divided into B1 and B2 subgroups, with their images being reconstructed by Karl iterative algorithm and AIIR, respectively. The CT and SD values of the ascending aorta, descending aorta, abdominal aorta, left common iliac artery and right common iliac artery were measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The subjective scoring of image quality was performed. The radiation dose parameters were documented.
Results Differences in the CT value, SD value, SNR and CNR of the three groups were statistically significant (P<0.001). The CT value, SNR and CNR of group B2 were significantly higher than those of group B1, while the SD value of group B2 was significantly lower than that of group B1 (P<0.017). There was no significant difference between the CT values of group A and those of group B2 (P>0.017). The SD values, SNR and CNR in group B2 were better than those in group A (P>0.017). There was significant difference in the subjective evaluation of image quality among the three groups (P<0.05), but there was no significant difference between group A and group B2 (P>0.017). The radiation dose and contrast medium dosage in group B decreased 84.14% and 37.08%, respectively, compared with those of group A.
Conclusion With the "three-low" technique combined with AIIR algorithm, the image quality of aortic CTA obtained is comparable to that of conventional dose scanning, while the radiation dose, contrast agent dosage and contrast agent flow rate of patients are significantly reduced.

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