高分辨CT扫描结合迭代重建技术在冠状动脉支架评估中的应用

Application of high-definition computed tomography scan combined with iterative reconstruction technique in the evaluation of coronary stent

目的探讨高分辨CT(HDCT)扫描结合迭代重建技术在冠状动脉支架血管评估中的价值。方法收集亳州市人民医院2020年8月至2022年12月经皮冠状动脉介入术后行冠状动脉血管造影(CCTA)检查病人61例。根据不同重建方法(Stand+ASiR-V:0%、Stand+ASiR-V:50%、HD Stand+ASiR-V:0%、HD Stand+ASiR-V:50%)重建出A、B、C、D四组图像。分别测量四组图像主动脉、心包脂肪、支架管腔内CT值、SD值(CT_(主)、SD_(主)、CT_(脂)、SD_(脂)、CT_(支)、SD_(支))、支架可视内径,计算CT_(差)、SNR_(主)、CNR_(主)、SNR_(支)、CNR_(支),评估图像主观质量评分,并进行统计学分析。结果A、B组CT_(支)(569.06±85.05、561.51±79.74比506.37±78.45、507.39±69.25)、CT_(差)(30.31±78.59、20.75±79.78比−32.83±74.98、−29.88±73.33)高于C、D组,支架可视内径低于C、D组[(1.85±0.46)mm、(1.89±0.41)mm比(2.15±0.43)mm、(2.14±0.45)mm],差异有统计学意义(P<0.05);A、B两组间及C、D两组间CT_(支)、CT_(差)值差异无统计学意义(P>0.05)。四组间CNR_(支)、SNR_(主)、CNR_(主)均为B组最高,A、D组次之,C组最低,差异有统计学意义(P<0.05)。支架可视内径对CT_(支)、SNR_(支)、CNR_(支)有负面影响,对SD支有正面影响,差异有统计学意义(P<0.05)。图像主观质量评分为D组最高,C组次之,A、B组最低,差异有统计学意义(P<0.001)。结论HDCT扫描能提高支架管腔清晰度,结合迭代重建技术能有效减低图像噪声,提高图像质量,有利于更准确评估冠状动脉支架血管情况。

Objective To investigate the value of high-definition computed tomography(HDCT)combined with iterative reconstruction technique in the evaluation of coronary stents.Methods Sixty-one patients who underwent coronary CT angiography(CCTA)after percutaneous coronary intervention in Bozhou People's Hospital from August 2020 to December 2022 were collected.According to different reconstruction methods(Stand+ASiR-V:0%,Stand+ASiR-V:50%,HD Stand+ASiR-V:0%,and HD Stand+ASiR-V:50%),the images of group A,B,C and D were reconstructed.The CT value and SD value of aorta,pericardial fat and stent lumen(CT_(aorta),SD_(aorta),CT_(fat),SD_(fat),CT_(stent),and SD_(stent),respectively)and stent visual diameter were measured,the CTdifference,SNR_(aorta),CNR_(aorta),SNR_(stent) and CNR_(stent) were calculated,and the subjective image quality scores were evaluated and statistically analyzed.Results Compared with group C and D,group A and B showed higher CT_(stent)(569.06±85.05,561.51±79.74 vs.506.37±78.45,507.39±69.25)and CT_(differenc)e(30.31±78.59,20.75±79.78 vs.−32.83±74.98,−29.88±73.33),while lower stent visual diameters[(1.85±0.46)mm,(1.89±0.41)mm vs.(2.15±0.43)mm,(2.14±0.45)mm],and the differences were statistically significant(all P<0.05).CT_(stent),CT_(difference) showed no statistical significance between group A and B,as well as between group C and D(all P>0.05).The CNR_(stent),SNR_(aorta) and CNR_(aorta) among the four groups were highest in group B,followed by group A and D,and the lowest in group C,and the differences were statistically significant(all P<0.05).The stent visual diameters had negative effect on CT_(stent),SNR_(stent) and CNR_(stent),and positive effect on SD_(stent),and the differences were statistically significant(all P<0.05).The subjective image quality score was the highest in group D,followed by group C,and the lowest in groups A and B,and the differences were statistically significant(all P<0.05).Conclusion The HDCT scan can increase the definition of stent lumen,combined with iterative reconstruction technique can effectively reduce image noise and improve image quality,which is conducive to more accurate assessment of coronary stent vessels.