基于SEMAR技术在CT检查中去除金属假体伪影临床应用价值的研究

The Clinical Significance of the Metal Arthroplasty Artifact Reduction Based on SEMAR Technology

目的探讨320排CT基于単能量金属伪影减除(SEMAR)技术去金属伪影在髋关节、膝关节置换术后检查中的临床应用价值。方法行髋关节置换术患者30例,膝关节置换术10例,于术后行320排CT检查,原始数据分别行常规重建及应用SEMAR技术重建两组图像。由3名放射科高年资医生对两组图像质量进行主观目测评分,测量放射状伪影长度以评价其伪影程度,并测量假体周围噪声值,对所获得数据采用SPSS 18.0进行配对t检验或Wilcoxon秩检验进行比较,并分析其临床价值。结果使用SEMAR技术所得图像的质量评分、金属伪影的长度及假体周围噪声值均优于不使用SEMAR技术,差异均有统计学意义,P值均<0.05;使用SEMAR技术单侧和双侧金属假体去伪影效果差别不大(P=0.083),差异无统计学意义;使用SEMAR技术骨计算方法去金属伪影效果优于软组织计算方法,P值<0.05,差异有统计学意义。结论 320排CT基于SEMAR技术能显著减少髋关节、膝关节的金属伪影,使含金属植入物的受检部位CT图像质量明显提高,具有较好的临床应用价值。

Objective To explore the clinical value of single energy metal artifact reduction（ SEMAR） using 320-row CT to reduce the metal artifact in patients with hip and knee arthroplasty. Methods Thirty patients after hip arthroplasty and ten patients after knee arthroplasty underwent 320-row CT examination. The original data were reconstructed respectively with conventional reconstruction and SEMAR technology. The image qualities were evaluated using a five-scale point by three radiologists. The length of radiated artifacts were measured to evaluate the degree of the artifacts,and the noise values around the prostheses were also measured. For all the evaluation of the results,the paired t test and Wilcoxon rank test were used for comparison,and the clinical value of SEMAR was analyzed. Results The image quality scores in SEMAR were higher than that in the original images,and the metal artifacts and noise values surrounding the prosthesis in SEMAR were less than that in the original images. The difference of the two methods was statistically significant（ P〈0. 05）,while there was no statistically significant difference between the unilateral and bilateral prosthesis replacement（ P = 0. 083）. The image quality scores in SEMAR using bone reconstruction were higher than that using soft tissue reconstruction,and the difference between the two methods was statistically significant（ P〈0. 05）. Conclusion SEMAR technology can significantly reduce the metal artifacts in hip and knee arthroplasty,and improve image quality obviously,which has the high clinical significance.