采用自动管电流调制和强适应性迭代剂量降低三维技术（AIDR3D）的CT冠状动脉造影的图像质量和辐射剂量
Image Quality and Radiation Dose of CT Coronary Angiography with Automatic Tube Current Modulation and Strong Adaptive Iterative Dose Reduction Three-Dimensional (AIDR3D).
作者信息
Shen Hesong, Dai Guochao, Luo Mingyue, Duan Chaijie, Cai Wenli, Liang Dan, Wang Xinhua, Zhu Dongyun, Li Wenru, Qiu Jianping
机构信息
Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Radiology, Chongqing Cancer Institute, Chongqing, China.
出版信息
PLoS One. 2015 Nov 23;10(11):e0142185. doi: 10.1371/journal.pone.0142185. eCollection 2015.
PURPOSE
To investigate image quality and radiation dose of CT coronary angiography (CTCA) scanned using automatic tube current modulation (ATCM) and reconstructed by strong adaptive iterative dose reduction three-dimensional (AIDR3D).
METHODS
Eighty-four consecutive CTCA patients were collected for the study. All patients were scanned using ATCM and reconstructed with strong AIDR3D, standard AIDR3D and filtered back-projection (FBP) respectively. Two radiologists who were blinded to the patients' clinical data and reconstruction methods evaluated image quality. Quantitative image quality evaluation included image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). To evaluate image quality qualitatively, coronary artery is classified into 15 segments based on the modified guidelines of the American Heart Association. Qualitative image quality was evaluated using a 4-point scale. Radiation dose was calculated based on dose-length product.
RESULTS
Compared with standard AIDR3D, strong AIDR3D had lower image noise, higher SNR and CNR, their differences were all statistically significant (P<0.05); compared with FBP, strong AIDR3D decreased image noise by 46.1%, increased SNR by 84.7%, and improved CNR by 82.2%, their differences were all statistically significant (P<0.05 or 0.001). Segments with diagnostic image quality for strong AIDR3D were 336 (100.0%), 486 (96.4%), and 394 (93.8%) in proximal, middle, and distal part respectively; whereas those for standard AIDR3D were 332 (98.8%), 472 (93.7%), 378 (90.0%), respectively; those for FBP were 217 (64.6%), 173 (34.3%), 114 (27.1%), respectively; total segments with diagnostic image quality in strong AIDR3D (1216, 96.5%) were higher than those of standard AIDR3D (1182, 93.8%) and FBP (504, 40.0%); the differences between strong AIDR3D and standard AIDR3D, strong AIDR3D and FBP were all statistically significant (P<0.05 or 0.001). The mean effective radiation dose was (2.55±1.21) mSv.
CONCLUSION
Compared with standard AIDR3D and FBP, CTCA with ATCM and strong AIDR3D could significantly improve both quantitative and qualitative image quality.
目的
探讨采用自动管电流调制（ATCM）扫描并通过强适应性迭代剂量降低三维重建（AIDR3D）重建的CT冠状动脉造影（CTCA）的图像质量和辐射剂量。
方法
连续收集84例CTCA患者进行研究。所有患者均采用ATCM扫描，并分别用强AIDR3D、标准AIDR3D和滤波反投影（FBP）进行重建。两名对患者临床资料和重建方法不知情的放射科医生评估图像质量。定量图像质量评估包括图像噪声、信噪比（SNR）和对比噪声比（CNR）。为了定性评估图像质量，根据美国心脏协会的修改指南将冠状动脉分为15个节段。使用4分制评估定性图像质量。基于剂量长度乘积计算辐射剂量。
结果
与标准AIDR3D相比，强AIDR3D的图像噪声更低，SNR和CNR更高，差异均有统计学意义（P<0.05）；与FBP相比，强AIDR3D使图像噪声降低46.1%，SNR提高84.7%，CNR提高82.2%，差异均有统计学意义（P<0.05或0.001）。强AIDR3D近端、中端和远端具有诊断图像质量的节段分别为336个（100.0%）、486个（96.4%）和394个（93.8%）；而标准AIDR3D分别为332个（98.8%）、472个（93.7%）、378个（90.0%）；FBP分别为217个（64.6%）、173个（34.3%）、114个（27.1%）；强AIDR3D具有诊断图像质量的节段总数（1216个，96.5%）高于标准AIDR3D（1182个，93.8%）和FBP（504个，40.0%）；强AIDR3D与标准AIDR3D、强AIDR3D与FBP之间的差异均有统计学意义（P<0.05或0.001）。平均有效辐射剂量为（2.55±1.21）mSv。
结论
与标准AIDR3D和FBP相比，采用ATCM和强AIDR3D的CTCA可显著提高定量和定性图像质量。
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