能谱CT不同虚拟单能量成像对冠状动脉运动追踪冻结技术改善冠状动脉搏动伪影的影响
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摘要
目的评价能谱CT不同虚拟单能量成像(VMS)对冠状动脉运动追踪冻结技术(SSF)改善冠状动脉搏动伪影的作用。方法连续搜集29例临床疑诊冠心病患者行冠状动脉CT造影检查。在70 keV条件下,以5%R-R间期为间隔重组图像,每个心动周期分布重建出使用SSF和不使用SSF(STD)的两组图像进行对比,选择出SSF改善搏动伪影最明显的心动期相(5分法评价标准);然后在这个心动期相内重建出SSF联合VMS(40~100 keV,10keV间隔)的图像。比较70 keV联合STD图像和7组VMS联合SSF图像间搏动伪影主观评分,测量并比较7组VMS图像主动脉根部的平均CT值。结果本组受检者平均心率(60. 66±6. 14) bpm(47~76 bpm)。低能量VMS图像主动脉内CT值较高,过低VMS(40 keV)或过高VMS(90~100 keV)不利于SSF纠正冠状动脉运动所造成的伪影,50~80 ke V图像的图像质量分数高于40 keV和90、100 keV(P <0. 05),90、100 keV时血管内CT值低,SSF不能很好纠正冠状动脉运动所造成的伪影。结论冠状动脉内CT值可能是影响SSF改善冠状动脉搏动伪影的重要因素,通过改变虚拟单能量水平可调整冠状动脉内过高或过低CT值,进而有利于SSF发挥作用。
Objective To investigate the effect of motion correction by Snap Shot freeze technique in coronary CT angiography obtained at virtual monochromatic spectral images. Methods 29 cases suspected of coronary artery disease were underwent dual-energy spectral CCTA. Images were reconstructed without( standard algorithm,STD) and with SSF at cardiac phases between 55 % and 85 % of the R-R interval in each patient. Comparisons were made between each image reconstructed with and without SSF. Selected the cardiac phase with the most improved per-vessel image quality( 5 scale) and then reconstruct VMS( 40-100 keV,with 10 keV interval) combined with SSF images. Compared STD images at 70 keV and VMS images with SSF on per-vessel image quality scores. Used the one-way ANOVA to compare the CT value of the aortic root for each VMS. Results The average patient heart rates were( 60. 66 ± 6. 14) bpm( 47-76 bpm). Low energy VMS images improved CT value compared with higher energy VMS images. The image quality scores for images at 50-80 keV were higher than those of 40 keV and 90,100 keV( P < 0. 05) because of the CT value intra-coronary were too high or too low,especially 90 and 100 keV for the low contrast agent density. Conclusion SSF can effectively reduce the motion artifacts when intra-coronary has a suitable contrast agent CT value,a suitable CT value may be a prerequisite for SSF to play the role,VMS can adjust the inappropriate CT value,and is helpful for motion artifact correction by SSF.
Objective To investigate the effect of motion correction by Snap Shot freeze technique in coronary CT angiography obtained at virtual monochromatic spectral images. Methods 29 cases suspected of coronary artery disease were underwent dual-energy spectral CCTA. Images were reconstructed without( standard algorithm,STD) and with SSF at cardiac phases between 55 % and 85 % of the R-R interval in each patient. Comparisons were made between each image reconstructed with and without SSF. Selected the cardiac phase with the most improved per-vessel image quality( 5 scale) and then reconstruct VMS( 40-100 keV,with 10 keV interval) combined with SSF images. Compared STD images at 70 keV and VMS images with SSF on per-vessel image quality scores. Used the one-way ANOVA to compare the CT value of the aortic root for each VMS. Results The average patient heart rates were( 60. 66 ± 6. 14) bpm( 47-76 bpm). Low energy VMS images improved CT value compared with higher energy VMS images. The image quality scores for images at 50-80 keV were higher than those of 40 keV and 90,100 keV( P < 0. 05) because of the CT value intra-coronary were too high or too low,especially 90 and 100 keV for the low contrast agent density. Conclusion SSF can effectively reduce the motion artifacts when intra-coronary has a suitable contrast agent CT value,a suitable CT value may be a prerequisite for SSF to play the role,VMS can adjust the inappropriate CT value,and is helpful for motion artifact correction by SSF.
引文
1李剑,石明国,印弘,等.冠状动脉CT成像中依据心率调节对比剂用量的可行性[J].中华放射学杂志,2016,50:870-873.
2 Mark DB,Berman DS,Budoff MJ,et al. ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 Expert Consensus Document on Coronary Computed Tomographic Angiography,:A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents[J]. Catheterization&Cardiovascular Interventions Official Journal of the Society for Cardiac Angiography&Interventions,2010,55:2663-2699.
3 王驰,丁莹莹,李鹍.双能量CT技术在骨肿瘤影像诊断中的研究进展[J].中国CT和MRI杂志,2017,15:145-147.
4 肖虎,党军,刘文亚,等.迭代重建联合单能谱成像在冠状动脉CT血管造影中的作用[J].中华实用诊断与治疗杂志,2017,31:902-905.
5 Leipsic J,Labounty TM,Hague CJ,et al. Effect of a novel vendorspecific motion-correction algorithm on image quality and diagnostic accuracy in persons undergoing coronary CT angiography without rate-control medications[J]. Journal of Cardiovascular Computed Tomography,2012,6:164-171.
6 Qianwen L,Pengyu L,Zhuangzhi S,et al. Effect of a novel motion correction algorithm(SSF)on the image quality of coronary CTA with intermediate heart rates:segment-based and vessel-based analyses[J]. European Journal of Radiology,2014,83:2024-2032.
7 范丽娟,孙凤伟,张计旺,等.冠状动脉追踪冻结技术对不控制心率受试者CT冠状动脉成像质量的影响[J].中华放射学杂志,2014,48:105-108.
8 Hong C,Becker CR,Huber A,et al. ECG-gated reconstructed multidetector row CT coronary angiography:effect of varying trigger delay on image quality[J]. Radiology,2001,220:712-717.
9 周俊,魏蓉.双低扫描技术结合双源CT Flash Spiral模式在冠状动脉成像中的应用[J].临床放射学杂志,2016,35:1437-1440.
10 孙明利,吕滨,吴润泽,等.冠状动脉造影和冠状动脉CT成像诊断冠心病的可重复性研究[J].中华放射学杂志,2012,46:104-109.
11 张伟杰,张惠英,陈伟彬,等.优化扫描范围对CT冠状动脉成像辐射剂量和图像质量的影响[J].临床放射学杂志,2016,35:799-802.
12 Min JK,Arsanjani R,Kurabayashi S,et al. Rationale and design of the Vi CTORY(Validation of an Intracycle CT Motion CORrection Algorithm for Diagnostic Accurac Y)trial[J]. Journal of Cardiovascular Computed Tomography,2013,7:200-206.
13 Machida H,Lin XZ,Fukui R,et al. Influence of the motion correction algorithm on the quality and interpretability of images of singlesource 64-detector coronary CT angiography among patients grouped by heart rate[J]. Japanese Journal of Radiology,2015,33:84-93.
14 张立仁.心脏能谱CT临床应用[M].人民军医出版社,2013,7-9.
15 Lee H,Kim JA,Lee JS,et al. Impact of a vendor-specific motion-correction algorithm on image quality,interpretability,and diagnostic performance of daily routine coronary CT angiography:influence of heart rate on the effect of motion-correction[J]. The International Journal of Cardiovascular Imaging,2014,30:1603-1612.
16 孙奕波,李铭,毛定飚,等.下肢动脉病变能谱CT血管成像图像后处理中最佳单能量图像的选择[J].中华放射学杂志,2013,47:269-272.
17 林晓珠,沈云,陈克敏. CT能谱成像的基本原理与临床应用研究进展[J].中华放射学杂志,2011,45:798-800.
18 陈安良,刘爱连,田士峰,等.低浓度对比剂腹部动脉能谱CT成像中最佳单能量的选择[J].中华医学杂志,2014,94:3382-3386.
19 Morgan DE. Dual-energy CT of the abdomen[J]. Abdominal Radiology,2014,39:108-134.
20 王雅雯,王若冰,吴宁.改善胸部CT增强效果和成像质量的能谱CT研究[J].放射学实践,2017,32:179-182.
2 Mark DB,Berman DS,Budoff MJ,et al. ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 Expert Consensus Document on Coronary Computed Tomographic Angiography,:A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents[J]. Catheterization&Cardiovascular Interventions Official Journal of the Society for Cardiac Angiography&Interventions,2010,55:2663-2699.
3 王驰,丁莹莹,李鹍.双能量CT技术在骨肿瘤影像诊断中的研究进展[J].中国CT和MRI杂志,2017,15:145-147.
4 肖虎,党军,刘文亚,等.迭代重建联合单能谱成像在冠状动脉CT血管造影中的作用[J].中华实用诊断与治疗杂志,2017,31:902-905.
5 Leipsic J,Labounty TM,Hague CJ,et al. Effect of a novel vendorspecific motion-correction algorithm on image quality and diagnostic accuracy in persons undergoing coronary CT angiography without rate-control medications[J]. Journal of Cardiovascular Computed Tomography,2012,6:164-171.
6 Qianwen L,Pengyu L,Zhuangzhi S,et al. Effect of a novel motion correction algorithm(SSF)on the image quality of coronary CTA with intermediate heart rates:segment-based and vessel-based analyses[J]. European Journal of Radiology,2014,83:2024-2032.
7 范丽娟,孙凤伟,张计旺,等.冠状动脉追踪冻结技术对不控制心率受试者CT冠状动脉成像质量的影响[J].中华放射学杂志,2014,48:105-108.
8 Hong C,Becker CR,Huber A,et al. ECG-gated reconstructed multidetector row CT coronary angiography:effect of varying trigger delay on image quality[J]. Radiology,2001,220:712-717.
9 周俊,魏蓉.双低扫描技术结合双源CT Flash Spiral模式在冠状动脉成像中的应用[J].临床放射学杂志,2016,35:1437-1440.
10 孙明利,吕滨,吴润泽,等.冠状动脉造影和冠状动脉CT成像诊断冠心病的可重复性研究[J].中华放射学杂志,2012,46:104-109.
11 张伟杰,张惠英,陈伟彬,等.优化扫描范围对CT冠状动脉成像辐射剂量和图像质量的影响[J].临床放射学杂志,2016,35:799-802.
12 Min JK,Arsanjani R,Kurabayashi S,et al. Rationale and design of the Vi CTORY(Validation of an Intracycle CT Motion CORrection Algorithm for Diagnostic Accurac Y)trial[J]. Journal of Cardiovascular Computed Tomography,2013,7:200-206.
13 Machida H,Lin XZ,Fukui R,et al. Influence of the motion correction algorithm on the quality and interpretability of images of singlesource 64-detector coronary CT angiography among patients grouped by heart rate[J]. Japanese Journal of Radiology,2015,33:84-93.
14 张立仁.心脏能谱CT临床应用[M].人民军医出版社,2013,7-9.
15 Lee H,Kim JA,Lee JS,et al. Impact of a vendor-specific motion-correction algorithm on image quality,interpretability,and diagnostic performance of daily routine coronary CT angiography:influence of heart rate on the effect of motion-correction[J]. The International Journal of Cardiovascular Imaging,2014,30:1603-1612.
16 孙奕波,李铭,毛定飚,等.下肢动脉病变能谱CT血管成像图像后处理中最佳单能量图像的选择[J].中华放射学杂志,2013,47:269-272.
17 林晓珠,沈云,陈克敏. CT能谱成像的基本原理与临床应用研究进展[J].中华放射学杂志,2011,45:798-800.
18 陈安良,刘爱连,田士峰,等.低浓度对比剂腹部动脉能谱CT成像中最佳单能量的选择[J].中华医学杂志,2014,94:3382-3386.
19 Morgan DE. Dual-energy CT of the abdomen[J]. Abdominal Radiology,2014,39:108-134.
20 王雅雯,王若冰,吴宁.改善胸部CT增强效果和成像质量的能谱CT研究[J].放射学实践,2017,32:179-182.