Große Hokamp Nils, Kessner Rivka, Van Hedent Steven, Graner Frank Philipp, Gupta Amit, Gilkeson Robert
J Comput Assist Tomogr. 2018 Nov/Dec;42(6):850-857. doi: 10.1097/RCT.0000000000000743.
This study aimed to evaluate image quality (IQ) of virtual monoenergetic images (VMIs) from novel spectral detector computed tomography angiography of the pulmonary arteries and to identify appropriate window settings for each kiloelectron volt level.
Forty consecutive patients were included in this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant study.Signal- and contrast-to-noise ratios were calculated within the pulmonary trunk, and pulmonary/lobar/segmental arteries were calculated. The IQ and diagnostic certainty were rated by 2 radiologists on 5-point scales. In addition, they recorded appropriate window settings (center/width) that were linearly modeled against attenuation within the pulmonary trunk to generate generable results.
Signal- and contrast-to-noise ratios, IQ, and diagnostic certainty are significantly increased in low-kiloelectron volt VMIs (≤60 keV). Interrater agreement was excellent (ĸ = 0.89). We developed 2 linear models (R: 0.91-0.97 and R: 0.43-0.91, respectively, P ≤ 0.01), that suggest appropriate window settings.
The VMIs from spectral detector computed tomography improve objective and subjective IQ in angiography of the pulmonary arteries, if window settings are adjusted; they can be automatically estimated using reported linear models.
本研究旨在评估新型光谱探测器计算机断层扫描肺动脉血管造影的虚拟单能图像（VMI）的图像质量（IQ），并确定每个千电子伏特水平的合适窗宽设置。
本机构审查委员会批准的、符合《健康保险流通与责任法案》的研究纳入了40例连续患者。计算肺动脉主干内的信号噪声比和对比噪声比，并计算肺叶/肺段动脉的信号噪声比和对比噪声比。由2名放射科医生对IQ和诊断确定性进行5分制评分。此外，他们记录了合适的窗宽设置（中心值/宽度），并根据肺动脉主干内的衰减进行线性建模以生成可推广的结果。
低千电子伏特VMI（≤60 keV）的信号噪声比、对比噪声比、IQ和诊断确定性显著增加。评分者间一致性良好（ĸ = 0.89）。我们开发了2个线性模型（R分别为0.91 - 0.97和0.43 - 0.91，P≤0.01），这些模型可提示合适的窗宽设置。
如果调整窗宽设置，光谱探测器计算机断层扫描的VMI可提高肺动脉血管造影的客观和主观IQ；可使用报告的线性模型自动估计窗宽设置。
