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MACTM技术在全髋关节置换术后CT去金属伪影中的应用

Application Value of CT Metal Artifact Correction Technology (MACTM) in CT Review after Total Hip Replacement

    摘要
  • 摘要:
      目的  探讨联影CT金属伪影校正技术（MACTM）在全髋关节置换术后CT复查中的应用价值。
      方法  回顾性收集2018年12月−2020年3月在我院行全髋关节置换术后CT复查的患者72例，将原始数据分别进行滤波反投影（FBP）和MACTM重建。在两组重建图像中选取3个相同的层面（髋臼起始层面、髋臼中心层面、髋臼下缘）并放置一致处勾画兴趣区（ROI），测量3个层面的金属高低密度伪影区、金属髋关节间隙、金属旁骨组织、肌肉、膀胱及皮下脂肪的CT值和图像噪声，计算其平均值，以皮下脂肪为参考计算金属植入物旁的骨组织、肌肉以及膀胱的信噪比（SNR）和对比噪声比（CNR），对两组数据进行比较。由2位放射科医生对两组重建图像进行盲法主观评分，并采用Kappa检验评价其一致性。
      结果  两组重建图像的高低密度伪影区及关节间隙CT值、图像噪声存在差异。MACTM组与FBP组相比，高密度区与关节间隙的CT值减少，低密度区CT值增加，各区的图像噪声值均减少。金属邻近骨组织、肌肉及膀胱的SNR和CNR，MACTM组均高于FBP组，差异有统计学意义（P<0.05）。MACTM组主观评分优于FBP组，差异有统计学意义（Z=−6.564，P<0.05）。在2位放射科医生主观评分的一致性检验中，FBP组一致性为中度（Kappa值为0.72），MAC组一致性为良好（Kappa值为0.85）。
      结论  MACTM重建在全髋关节置换术后CT复查中能够减少金属伪影，使关节间隙显示更加清晰，提高了CT图像质量，效果优于FBP重建。

     

    Abstract:
      Objective  To evaluate the application value of CT metal artifact correction technology (MACTM) in CT review after total hip replacement.
      Methods   A total of 72 patients who underwent CT re-examination after total hip replacement from December 2018 to March 2020 were enrolled, and the original data were reconstructed by filter backup projection （FBP） and MAC. Select three identical levels in the two sets of reconstructed images and place the same ROI. The selected levels were the initial level, central level, and lower edge of acetabulum. Measure the CT and noise (SD) of metal high and low density artifacts of the three levels area, as well as metal hip joint space, metal para-bone tissue, muscle, bladder and subcutaneous fat, and calculate the average value. Subcutaneous fat value was used as a reference to calculate the SNR and CNR of metal implant para-bone tissue, muscle and bladder. Two radiologists scored the two groups of reconstructed images using blinded method, Kappa’s test was used to compare the homogeneity.
      Results  There were differences between the two groups of reconstructed images in high- and low-density artifact areas, joint gap CT values, and image noise. Compared with the FBP group, the CT value of the high-density area and the joint space of the MAC group decreased, the CT value of the low-density area increased, and the noise value of each area decreased. The SNR and CNR of metal adjacent bone tissue, muscle and bladder were higher in the MAC group than those in the FBP group, and the difference was statistically significant (P<0.05). The difference in subjective scores between the two groups was statistically significant (Z=−6.564, P<0.05). 2 radiologists had moderate consistency with Kappa value of 0.72 on FBP group, and good consistency with Kappa value of 0.85 on MAC group.
      Conclusion  MACTM in CT review after total hip replacement can reduce metal artifacts, make the joint space more clear, and improve the quality of CT images.

     

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