新一代心血管专用CT高清扫描模式与迭代重建技术对冠状动脉支架植入术后CCTA成像的价值

Value of High-Definition Cardiovascular CT Scanning Mode and Adaptive Statistical Iterative Reconstruction-CV Technique in Coronary CT Angiography Imaging After Coronary Stent Implantation

目的探讨应用新一代心血管CT对冠状动脉支架植入术后CCTA成像的价值,评价新设备下高清扫描模式联合迭代重建技术对冠状动脉及冠状动脉支架成像质量的影响。方法53例冠状动脉支架(105个)植入术后患者在心血管CT扫描仪(Cardiographe CT,GE Healthcare)下行心血管冠状动脉CT血管造影(Coronary CT Angiography,CCTA)检查,应用高清扫描模式联合迭代重建技术对原始数据进行重建,标准重建算法(CV standard)采用ASIR-CV 50%、70%、90%权重三组迭代重建序列,再使用高清标准重建算法(HD standard)及高清细节重建算法(HD detail)联合ASIR-CV 70%进行重建,分别从客观评价[CT值、噪声、信噪比(Signal to Noise Ratio,SNR)和对比噪声(Contrast to Noise Ratio,CNR)]及主观评价两方面对图像质量进行分析,比较各组图像之间的差异。结果随着ASIR-CV迭代算法权重的增加,三组的CT值没有显著性差异,CNR和SNR逐渐升高、噪声逐渐降低,50%、70%、90%权重组及两两比较均有显著性差异(P<0.05)。随着重建算法的锐利度增加,CV standard、HD standard、HD detail三组的CT值没有显著性差异,CNR和SNR逐渐降低、噪声逐渐增加,三组及组内两两比较均有显著性差异(P<0.05)。随着不同ASIR-CV重建权重的增加,图像的主观评价结果无显著性差异(P>0.05);而HD detail重建方式的主观评价高于HD standard和CV standard(P<0.05),三组间有显著性差异。结论新一代心血管专用CT高清扫描模式与迭代重建技术可以提高冠状动脉及冠状动脉支架的图像质量,可为冠状动脉支架植入术后患者的复查提供临床满意的高质量图像。

Objective To explore the value of dedicated cardiovascular CT scanner and evaluate the influence of adaptive statistical iterative reconstruction-CV(ASIR-CV)technique in high-resolution CT coronary stent imaging with different convolution kernels.Methods A total of 53 patients with 105 coronary stents were performed coronary computed tomography angiography(CCTA)by using dedicated cardiovascular CT scanner(CardioGraphe CT,GE Healthcare).Images were reconstructed at convolution kernel of CV-standard,HD-standard and HD detail with ASIR-CV technique as three groups.Subjective and objective evaluation of image quality of the three groups were performed and compared by two experienced radiologists independently.Results With the increase of the weight of ASIR-CV,there was no significant difference in CT values among the three groups;While the noise of the image gradually decreased,contrast to noise ratio(CNR)and signal to noise ratio(SNR)increased.The 50%,70%,and 90%weight groups and pairwise comparisons had significant differences(P<0.05).With the increase of the sharpness of the reconstruction algorithm,there was no significant difference in CT values among the three groups;While CNR and SNR gradually decreased and noise gradually increased,there were significant differences among the three groups and pairwise comparisons(P<0.05).With the increase of different ASIR-CV weights,there was no significant difference in subjective evaluation results(P>0.05);the subjective evaluation of HD detail reconstruction was higher than that of HD standard and CV standard(P<0.05),and there was significant difference among the three groups.Conclusion The high-definition scanning mode and ASIR-CV technique can improve the image quality of coronary stent,and provide high-quality images with clinical satisfaction for the reexamination after coronary stent implantation.