高级血管分析软件与容积CT数字减影血管造影提高CT血管成像去骨效果的可靠性研究

Reliability study of advanced vascular analysis software and volume CT digital subtraction angiography for bone subtraction on CT angiography

目的:评价高级血管分析软件(advanced vascular analysis,AVA)与容积CT数字减影血管造影(volume computed tomographic digital subtraction angiography,VCTDSA)技术在正常头颈CT血管成像(computed tomographic angiography,CTA)中去骨效果的可靠性。方法:分析重庆医科大学附属第一医院30名正常头颈CT血管成像(CT angiography,CTA)受检者的影像资料。同一操作者使用AVA软件和VCTDSA对原始图像去骨,记录自动去骨、手动去骨及总去骨时间,从血管完整性、图像质量、假性血管狭窄三方面评价VR和MIP图像。去骨时间比较用非参数Mann-Whitney U检验;血管完整性用配对卡方检验;图像质量和假性血管狭窄评价用相关样本的秩和检验。结果:VCTDSA自动去骨、手动去骨及去骨总时间分别为14.5(13,20.25)s、399(353.75,501.75)s及415.5(371.5,516)s,AVA自动去骨、手动去骨及去骨总时间分别为116.5(109,123.25)s、11.5(0,71.25)s及140(115.5,188)s,AVA手动去骨和去骨总时间短于VCTDSA(P<0.01);M4~M5、大脑桥静脉、上矢状窦、横窦、乙状窦AVA显示率为0,VCTDSA显示率达93.33%(140/150)(P<0.01);图像质量方面,ICA2段,VCTDSAⅠ级图像为86.21%(25/29),AVAⅠ级图像仅为44.83(13/29);ICA6,VCTDSAⅠ级图像分别为96.55%(28/29),AVAⅠ级图像仅为58.62%(17/29),VCTDSA优于AVA(P<0.01);假性血管狭窄发生率,VCTDSA1.41%(10/711),AVA1.13%(8/711),差异无统计学意义(P>0.01)。结论:VCTDSA技术CTA去骨效果可靠性更高,应作为CTA优选去骨方法。

Objective:To evaluate the reliability of advanced vascular analysis(AVA)software and volume computed tomography digital subtraction angiography(VCTDSA)for bone subtraction on computed tomography angiography(CTA)of the normal head and neck. Methods:The imaging data of normal head and neck CTA for 30 subjects in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The same operator used AVA software and VCTDSA for bone-subtraction in the original images,recorded the time of automatic subtraction,manual subtraction,and total subtraction,and evaluated the VR and MIP images in the aspects of vascular integrity,image quality,and false vascular stenosis. The Mann-Whitney U test was used to compare the subtraction time,the paired chi-square test was used to evaluate vascular integrity,and the rank sum test for dependent samples was used to evaluate image quality and false vascular stenosis. Results:The time of automatic subtraction,manual subtraction,and total subtraction of VCTDSA was 14.5(13,20.25) seconds,399(353.75,501.75) seconds,and 415.5(371.5,516) seconds,respectively,while that of AVA was 116.5(109,123.25)seconds,11.5(0,71.25)seconds,and 140(115.5,188)seconds,respectively. The time of manual subtraction and total subtraction of AVA was significantly shorter than that of VCTDSA(P<0.01). The display rates of the M4 and M5 regions,intracranial bridging veins,superior sagittal sinus,transverse sinus,and sigmoid sinus for AVA and VCTDSA were 0 and 93.33%(140/150),respectively,with a significant difference(P<0.01). The image quality of internal carotid artery(ICA)2 and ICA6 of VCTDSA was better than that of AVA(P<0.01);the percentages of grade I images of ICA2 and ICA6 on VCTDSA were 86.21%(25/29)and 96.55%(28/29),respectively,versus44.83%(13/29)and 58.62%(17/29)for AVA. The rate of false vascular stenosis showed no significant difference between CTDSA and AVA[1.41%(10/711)vs. 1.13%(8/711),P>0.01]. Conclusion:VCTDSA has a more reliable bone-subtraction effect than AVA on CTA,and it should be used as the preferred bone-subtraction method.