Kahn Johannes, Grupp Ulrich, Kaul David, Böning Georg, Lindner Tobias, Streitparth Florian
Department of Radiology, Charité, Berlin, Germany
Department of Radiology, Charité, Berlin, Germany.
Acta Radiol. 2016 Mar;57(3):362-9. doi: 10.1177/0284185115580839. Epub 2015 Apr 6.
Rising numbers of computed tomography (CT) examinations worldwide have led to a focus on dose reduction in the latest developments in CT technology. Iterative reconstruction (IR) models bear the potential to effectively reduce dose while maintaining adequate image quality.
To assess the impact of adaptive statistical iterative reconstruction (ASIR) technique on dose reduction and image quality in a dedicated whole body CT (WBCT) protocol for trauma patients.
A total of 122 subjects with multiple trauma was prospectively included in our study. Subjects who had to undergo a WBCT following a severe trauma were randomly assigned to two different groups: Group A was examined with an ASIR protocol for the body series (n = 64), group B (n = 58) was examined using a standard filtered back projection (FBP) protocol. Image quality was assessed both quantitatively by calculating signal-to-noise ratio (SNR) and contrast-to-noise ratios (CNRs) and qualitatively by two observers who evaluated image quality using a 5-point scale system. Applied dose was analyzed as CTDIvol (mGy), total DLP (mGyxcm), and effective dose (mSv).
Applied dose for the body series in group A was about 23% lower than in group B (P < 0.05). SNR and CNRs for different tissues were not significantly different. Subjective image quality ratings were excellent and showed no significant difference, with a high inter-reader agreement.
ASIR contributes to a relevant dose reduction without any loss of image quality in a dedicated WBCT protocol for patients with multiple trauma.
全球范围内计算机断层扫描（CT）检查数量不断增加，这使得CT技术的最新发展聚焦于剂量降低。迭代重建（IR）模型有潜力在保持足够图像质量的同时有效降低剂量。
评估自适应统计迭代重建（ASIR）技术对创伤患者专用全身CT（WBCT）检查方案中剂量降低和图像质量的影响。
本研究前瞻性纳入了122例多发伤患者。严重创伤后必须接受WBCT检查的患者被随机分为两组：A组采用ASIR方案进行体部扫描（n = 64），B组（n = 58）采用标准滤波反投影（FBP）方案进行检查。通过计算信噪比（SNR）和对比噪声比（CNR）进行图像质量的定量评估，并由两名观察者使用5分制系统对图像质量进行定性评估。将应用剂量分析为容积CT剂量指数（CTDIvol，mGy）、总剂量长度乘积（DLP，mGyxcm）和有效剂量（mSv）。
A组体部扫描的应用剂量比B组低约23%（P < 0.05）。不同组织的SNR和CNR无显著差异。主观图像质量评分均为优秀，且无显著差异，观察者间一致性高。
在多发伤患者专用的WBCT方案中，ASIR有助于显著降低剂量，且图像质量无任何损失。
