Bodelle Boris, Fischbach Constanze, Booz Christian, Yel Ibrahim, Frellesen Claudia, Beeres Martin, Vogl Thomas J, Scholtz Jan-Erik
Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Eur J Radiol. 2017 Apr;89:208-214. doi: 10.1016/j.ejrad.2017.01.027. Epub 2017 Feb 6.
To investigate image quality, presence of motion artifacts and effects on radiation dose of 80kVp high-pitch dual-source CT (DSCT) in combination with an advanced modeled iterative reconstruction algorithm (ADMIRE) of the pediatric chest compared to single-source CT (SSCT).
The study was approved by the institutional review board. Eighty-seven consecutive pediatric patients (mean age 9.1±4.9years) received either free-breathing high-pitch (pitch 3.2) chest 192-slice DSCT (group 1, n=31) or standard-pitch (pitch 1.2) 128-slice SSCT (group 2, n=56) with breathing-instructions by random assignment. Tube settings were similar in both groups with 80 kVp and 74 ref. mAs. Images were reconstructed using FBP for both groups. Additionally, ADMIRE was used in group 1. Effective thorax diameter, image noise, and signal-to-noise ratio (SNR) of the pectoralis major muscle and the thoracic aorta were calculated. Motion artifacts were measured as doubling boarders of the diaphragm and the heart. Images were rated by two blinded readers for overall image quality and presence of motion artifacts on 5-point-scales. Size specific dose estimates (SSDE, mGy) and effective dose (ED, mSv) were calculated.
Age and effective thorax diameter showed no statistically significant differences in both groups. Image noise and SNR were comparable (p>0.64) for SSCT and DSCT with ADMIRE, while DSCT with FBP showed inferior results (p<0.01). Motion artifacts were reduced significantly (p=0.001) with DSCT. DSCT with ADMIRE showed the highest overall IQ (p<0.0001). Radiation dose was lower for DSCT compared to SSCT (median SSDE: 0.82mGy vs. 0.92mGy, p<0.02; median ED: 0.4 mSv vs. 0.48mSv, p=0.02).
High-pitch 80kVp chest DSCT in combination with ADMIRE reduces motion artifacts and increases image quality while lowering radiation exposure in free-breathing pediatric patients without sedation.
与单源CT（SSCT）相比，研究80kVp高螺距双源CT（DSCT）联合先进的模型迭代重建算法（ADMIRE）在小儿胸部成像中的图像质量、运动伪影情况及对辐射剂量的影响。
本研究经机构审查委员会批准。87例连续的儿科患者（平均年龄9.1±4.9岁）通过随机分组，分别接受自由呼吸高螺距（螺距3.2）胸部192层DSCT扫描（第1组，n = 31）或标准螺距（螺距1.2）128层SSCT扫描（第2组，n = 56），并给予呼吸指导。两组的管电压设置相似，均为80 kVp和74参考mAs。两组图像均采用滤波反投影（FBP）重建。此外，第1组使用ADMIRE。计算有效胸廓直径、图像噪声以及胸大肌和胸主动脉的信噪比（SNR）。运动伪影通过测量膈肌和心脏的双边影来评估。由两名盲法阅片者对图像的整体图像质量和运动伪影情况进行5分制评分。计算大小特异性剂量估计值（SSDE，mGy）和有效剂量（ED，mSv）。
两组患者的年龄和有效胸廓直径无统计学显著差异。SSCT和采用ADMIRE的DSCT的图像噪声和SNR相当（p>0.64），而采用FBP的DSCT结果较差（p<0.01）。DSCT显著减少了运动伪影（p = 0.001）。采用ADMIRE的DSCT显示出最高的整体图像质量（p<0.0001）。DSCT的辐射剂量低于SSCT（SSDE中位数：0.82mGy对0.92mGy，p<0.02；ED中位数：0.4 mSv对0.48mSv，p = 0.02）。
80kVp高螺距胸部DSCT联合ADMIRE可减少自由呼吸的小儿患者在无镇静情况下的运动伪影，提高图像质量，同时降低辐射暴露。
