高级模型迭代重建算法的低管电压扫描模式用于双源CT肝扫描的价值

Effect of low-tube voltage scanning mode with ADMIRE on radiation dose and image quality in dual-source CT liver scans

目的探讨高级模型迭代重建算法(ADMIRE)的低管电压扫描模式用于双源CT肝扫描的价值。方法选择2020年3月至2023年3月淮安市第一人民医院收治的疑似肝脏疾病行上腹部CT扫描的102例患者,采用随机数字表法分为A组、B组、C组,各34例。患者均接受双源CT上腹部平扫及增强扫描,A组采用ADMIRE低管电压(70 kV),B组采用ADMIRE标准管电压(120 kV),C组采用常规FBP(100 kV)。比较3组图像质量客观指标、图像主观评分及辐射剂量。统计3组肝脏病变诊断情况。结果A、B、C组肝实质CT值分别为(105.63±9.81)HU、(107.91±8.52)HU、(103.74±8.94)HU,皮下脂肪CT值分别为(-97.82±5.37)HU、(-96.33±5.59)HU、(-96.14±4.25)HU,背景空气CT值分别(-999.37±14.23)HU、(-995.42±11.36)HU、(-997.06±15.75)HU,比较差异无统计学意义(P>0.05)。对比噪声比(CNR)分别为(15.82±0.94)、(16.29±0.61)、(18.74±0.89),信噪比(SNR)分别为(9.74±0.86)、(10.29±0.77)、(8.41±0.49),标准差(SD)分别为(10.09±1.98)、(10.58±2.35)、(12.36±2.19),图像质量评分分别为(4.86±0.11)、(4.91±0.08)、(4.38±0.17),A组和B组图像CNR、SD低于C组,SNR、图像质量评分高于C组(P<0.05);A组和B组图像的CNR、SNR、SD、图像质量评分比较差异无统计学意义(P>0.05)。三组剂量长度乘积(DLP)分别为(67.82±19.35)mGy·cm、(126.93±23.88)mGy·cm、(141.25±29.76)mGy·cm,容积CT剂量指数(CTDI vol)分别为(3.82±0.95)mGy、(6.39±1.12)mGy、(8.14±1.36)mGy,有效辐射剂量(ED)分别为(1.26±0.28)mSv、(1.94±0.39)mSv、(2.27±0.41)mSv,A组和B组图像DLP、CTDI vol、ED均低于C组,且A组图像DLP、CTDI vol、ED均低于B组(P<0.05)。3种重建图像对肝脏病变的诊断与临床诊断一致。结论ADMIRE的低管电压扫描模式用于双源CT肝扫描有利于减少图像噪声和辐射剂量,并且能保证较高的图像质量。

Objective To investigate the efficacy of utilizing the low-tube voltage scanning mode with the Advanced Model Iterative Reconstruction Algorithm(ADMIRE)in dual-source CT liver scanning.Methods From March 2020 to March 2023,a cohort of 102 patients with suspected liver diseases,undergoing upper abdominal CT scans at our hospital,were randomly assigned into three groups(A,B,and C),each comprising 34 patients.All groups underwent dual-source CT plain and enhanced scans of the upper abdomen.Group A utilized the ADMIRE low tube voltage(70 kV),Group B utilized the ADMIRE standard tube voltage(120 kV),and Group C adopted conventional FBP(100 kV).Objective image quality metrics,subjective scores,radiation doses,and diagnostic outcomes of liver lesions were compared among the three groups.Results The hepatic parenchyma CT values for the three groups were(105.63±9.81),(107.91±8.52),and(103.74±8.94)respectively,while the CT values of subcutaneous fat were(-97.82±5.37),(-96.33±5.59)and(-96.14±4.25)respectively.Background air CT values were consistent among the three group:(-999.37±14.23),(-995.42±11.36)and(-997.06±15.75),with no statistically significant differences observed(P>0.05).Contrast noise ratio(CNR)values were(15.82±0.94),(16.29±0.61)and(18.74±0.89),and signal-to-noise ratio(SNR)values were(9.74±0.86),(10.29±0.77)and(8.41±0.49),respectively.Standard deviation(SD)values were(10.09±1.98),(10.58±2.35)and(12.36±2.19),while image quality scores were(4.86±0.11),(4.91±0.08)and(4.38±0.17),respectively.CNR and SD were lower in groups A and B compared to group C,while SNR and image quality scores were higher in groups A and B group(P<0.05).No significant differences were observed between groups A and B in terms of CNR,SNR,SD,and image quality scores(P>0.05).The dose-length product(DLP)values were(67.82±19.35)mGy·cm,(126.93±23.88)mGy·cm,(141.25±29.76)mGy·cm,respectively,With corresponding Volume CT Dose Index(CTDI vol)values of(3.82±0.95)mGy,(6.39±1.12)mGy,(8.14±1.36)mGy,and effective radiation dose(ED)values of(1.26±0.28)mSv,(1.94±0.39)mSv,(2.27±0.41)mSv,respectively.DLP,CTDI vol and ED were lowerin groups A and B compared to group C,with group A showing lower values than group B(P<0.05).Diagnosis of liver lesions based on the three reconstructed images aligned with clinical diagnosis.Conclusion The implementation of the low-tube voltage scanning mode of ADMIRE in dual-source CT liver scanning demonstrates notable benefits in reducing image noise and radiation dose while maintaining high image quality.These findings underscore its potential for widespread adoption and clinical utility.