容积CT数字减影血管造影与匹配蒙片去骨法对正常人头颈CT血管成像减影效果的比较

Comparison of Volume Computed Tomographic Digital Subtraction Angiography and Matched Mask Bone Elimination in the Subtraction Image Effect of the Head and Neck CT Angiography

目的比较容积CT数字减影血管造影(VCTDSA)与匹配蒙片去骨(MMBE)法在正常人头颈CT血管成像(CTA)中的减影效果。资料与方法回顾性分析2016年9月—2017年7月重庆医科大学附属第一医院30名行头颈CTA检查显示正常者的影像资料。同一操作者分别使用VCTDSA法与MMBE法对其原始图像进行后处理,分别记录自动减影时间、手动减影时间、总减影时间,并从血管的显示、杂质的干扰等方面对减影后的容积再现、最大密度投影图进行质量评价。比较2个工作站总减影时间,并评价图像等级。结果 VCTDSA法和MMBE法的总减影时间分别为(355.29±64.87)s、(93.04±16.99)s,差异有统计学意义(P<0.01)。两者手动减影后的整体图像质量,VCTDSA法最多为Ⅰ级(73.33%,22/30),MMBE法最多为Ⅲ级(66.67%,20/30);下切上视图的图像质量,VCTDSA法最多为Ⅰ级(60.00%,18/30),MMBE法最多为Ⅲ级(66.67%,20/30)。总体图像质量,两种方法处理后差异有统计学意义(P<0.01)。30名受试者采用两种减影技术各获得300张最大密度投影图,其中采用VCTDSA法,Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级图像数分别为252张、13张、8张和27张,采用MMBE法Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级图像数分别为248张、31张、13张和8张,两者图像质量差异有统计学意义(Z=-3.125,P=0.002)。结论MMBE法较VCTDSA法对头颈CTA的减影后处理更节约时间,VCTDSA对头颈CTA显示更好,可作为优先选择,两种减影方法的最大密度投影图均显示较好。

Purpose To compare the subtraction image effect of volume computed tomographic digital subtraction angiography（VCTDSA） with the subtraction image effect of matched mask bone elimination（MMBE） in the head and neck angiography（CTA） of healthy individuals.Materials and Methods The imaging data of thirty patients who completed head and neck CTA examination and were considered to be healthy individuals from September 2016 to July 2017 in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.The same operator respectively used VCTDSA and MMBE to post-process the original images.The automatic subtraction image time,manual subtraction image time,and total subtraction image time were recorded respectively,and the quality of volume rendering and maximum intensity projection images after subtraction image were evaluated from the aspects of the vascular display and the interference of impurities.The total subtraction image time of two workstations was compared; and the image grade was evaluated.Results The total time of subtraction image： VCTDSA（355.29±64.87） s and MMBE（93.04±16.99） s.The difference between the two was statistically significant（P〈0.01）.The overall image quality after manual subtraction image： VCTDSA was mainly gradeⅠ（73.33%,22/30）,and MMBE was mainly grade Ⅲ（66.67%,20/30）.For the image quality of undercutting top view： VCTDSA was mainly grade I（60.00 %,18/30）,and MMBE was mainly grade Ⅲ（66.67%,20/30）.The difference in overall image quality treated by above two methods was statistically significant（P〈0.01）.300 maximum intensity projection images were obtained respectively from the 30 subjects by the two subtraction image techniques.The numbers of grade Ⅰ,Ⅱ,Ⅲ,and Ⅳ were 252,13,8 and 27 respectively when the VCTDSA method was used,and the numbers of grade Ⅰ,Ⅱ,Ⅲ and Ⅳ were 248,31,13 and 8 respectively when the MMBE method was used; the difference in the image quality between the two were statistically significant（Z=-3.125,P=0.002）.ConclusionCompared with VCTDSA,MMBE can save more time in the post-processing of head and neck CTA,and VCTDSA can be used as a preferred choice due to its better display in the head and neck CTA images.The MIP images of the two subtraction image methods can be shown well.