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用于单节拍冠状动脉CT血管造影的新型自动冠状动脉特异性最佳心动周期选择算法的临床评估

Clinical evaluation of new automatic coronary-specific best cardiac phase selection algorithm for single-beat coronary CT angiography.

作者信息

Wang Hui, Xu Lei, Fan Zhanming, Liang Junfu, Yan Zixu, Sun Zhonghua

机构信息

Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Department of Radiology, Beijing Huairou Hospital, Beijing, China.

出版信息

PLoS One. 2017 Feb 23;12(2):e0172686. doi: 10.1371/journal.pone.0172686. eCollection 2017.

Abstract

The aim of this study was to evaluate the workflow efficiency of a new automatic coronary-specific reconstruction technique (Smart Phase, GE Healthcare-SP) for selection of the best cardiac phase with least coronary motion when compared with expert manual selection (MS) of best phase in patients with high heart rate. A total of 46 patients with heart rates above 75 bpm who underwent single beat coronary computed tomography angiography (CCTA) were enrolled in this study. CCTA of all subjects were performed on a 256-detector row CT scanner (Revolution CT, GE Healthcare, Waukesha, Wisconsin, US). With the SP technique, the acquired phase range was automatically searched in 2% phase intervals during the reconstruction process to determine the optimal phase for coronary assessment, while for routine expert MS, reconstructions were performed at 5% intervals and a best phase was manually determined. The reconstruction and review times were recorded to measure the workflow efficiency for each method. Two reviewers subjectively assessed image quality for each coronary artery in the MS and SP reconstruction volumes using a 4-point grading scale. The average HR of the enrolled patients was 91.1±19.0bpm. A total of 204 vessels were assessed. The subjective image quality using SP was comparable to that of the MS, 1.45±0.85 vs 1.43±0.81 respectively (p = 0.88). The average time was 246 seconds for the manual best phase selection, and 98 seconds for the SP selection, resulting in average time saving of 148 seconds (60%) with use of the SP algorithm. The coronary specific automatic cardiac best phase selection technique (Smart Phase) improves clinical workflow in high heart rate patients and provides image quality comparable with manual cardiac best phase selection. Reconstruction of single-beat CCTA exams with SP can benefit the users with less experienced in CCTA image interpretation.

摘要

本研究的目的是评估一种新的冠状动脉特异性自动重建技术(智能期相,通用电气医疗集团 - SP)与专家手动选择(MS)相比,在高心率患者中选择冠状动脉运动最小的最佳心动期相时的工作流程效率。本研究共纳入46例心率高于75次/分钟且接受单心跳冠状动脉计算机断层扫描血管造影(CCTA)的患者。所有受试者的CCTA均在一台256排CT扫描仪(Revolution CT,通用电气医疗集团,美国威斯康星州沃基沙)上进行。使用SP技术时,在重建过程中以2%的期相间隔自动搜索采集的期相范围,以确定冠状动脉评估的最佳期相,而对于常规专家MS,以5%的间隔进行重建并手动确定最佳期相。记录重建和审查时间以衡量每种方法的工作流程效率。两名审查员使用4分制评分量表对MS和SP重建容积中每条冠状动脉的图像质量进行主观评估。纳入患者的平均心率为91.1±19.0次/分钟。共评估了204条血管。使用SP时的主观图像质量与MS相当,分别为1.45±0.85和1.43±0.81(p = 0.88)。手动选择最佳期相的平均时间为246秒,SP选择为98秒,使用SP算法平均节省时间148秒(60%)。冠状动脉特异性自动心脏最佳期相选择技术(智能期相)改善了高心率患者的临床工作流程,并提供了与手动心脏最佳期相选择相当的图像质量。使用SP对单心跳CCTA检查进行重建可使CCTA图像解读经验较少的用户受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3fc/5322912/6d50e384a015/pone.0172686.g001.jpg

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