Namimoto Tomohiro, Oda Seitaro, Utsunomiya Daisuke, Shimonobo Toshiaki, Morita Sosuke, Nakaura Takeshi, Yamashita Yasuyuki
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
J Comput Assist Tomogr. 2012 Jul-Aug;36(4):495-501. doi: 10.1097/RCT.0b013e31825b821f.
To intraindividually compare a low-tube voltage, low-contrast material dose computed tomography (CT) reconstructed with iterative reconstruction (IR) algorithm at standard tube voltage reconstructed with filtered back projection (FBP) and standard-contrast material dose during liver dynamic CT.
Twenty-five patients with liver cirrhosis underwent 64-section multidetector CT. One hundred twenty kilovolt (peak) (kV[p]) with standard contrast material dose of 600 mg of iodine per kilogram (protocol A) and 80 kV(p) with low-contrast material dose of 450 mg of iodine per kilogram (protocol B) CT image sets were reconstructed by using FBP algorithm and that of using IR algorithm with a 60%/40% blend of IR-FBP reconstruction at 80-kV(p) image set (protocol C). Scans obtained during 3 hepatic phases were subjected to quantitative and qualitative analysis.
The mean radiation dose and the contrast medium dose were significantly lower under protocols B and C than under protocol A. In all hepatic phases, all signal-to-noise and contrast-to-noise ratios were greater under protocol C than under other protocols at all anatomic sites. Qualitative analysis showed that image noise and diagnostic acceptability were significantly higher under protocol C.
In all hepatic phases, a low-tube voltage, low-contrast material dose CT with IR algorithm yielded better contrast enhancement and image quality than a standard tube voltage, standard contrast material dose CT with FBP in thin adult patients.
在肝脏动态CT检查中,对采用迭代重建(IR)算法重建的低管电压、低对比剂剂量计算机断层扫描(CT)与采用滤波反投影(FBP)算法在标准管电压下重建且使用标准对比剂剂量的CT进行个体内比较。
25例肝硬化患者接受64层多排CT检查。采用FBP算法重建120千伏(峰值)(kV[p])、标准对比剂剂量为每千克600毫克碘的CT图像集(方案A),以及采用FBP算法重建80 kV(p)、低对比剂剂量为每千克450毫克碘的CT图像集(方案B),并采用IR算法在80 kV(p)图像集上以60%/40%的IR-FBP混合重建方式重建(方案C)。对肝脏三期扫描获得的图像进行定量和定性分析。
方案B和C下的平均辐射剂量和对比剂剂量显著低于方案A。在所有肝脏期,方案C在所有解剖部位的所有信噪比和对比噪声比均高于其他方案。定性分析表明,方案C下的图像噪声和诊断可接受性显著更高。
在所有肝脏期,对于体型较瘦的成年患者,采用IR算法的低管电压、低对比剂剂量CT比采用FBP算法的标准管电压、标准对比剂剂量CT具有更好的对比增强效果和图像质量。