Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 305 Gudeok-Ro, Seo-Gu, Busan 49241, Korea.
Department of Radiology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
AJR Am J Roentgenol. 2019 Sep;213(3):659-666. doi: 10.2214/AJR.18.20827. Epub 2019 Apr 30.
The purpose of this study was to evaluate and compare the diagnostic performance and image quality of low-dose CT performed with adaptive statistical iterative reconstruction (ASIR)-V with those of routine-dose CT with filtered back projection (FBP) in the evaluation of abdominal organ injury. The study enrolled 197 patients with trauma who underwent multiphase abdominal CT, including routine-dose portal venous phase imaging with FBP and low-dose delayed phase imaging with 50% ASIR-V. The presence of abdominal organ injuries (liver, spleen, pancreas, kidney) was reviewed, and injuries were graded according to American Association for the Surgery of Trauma (AAST) scales. CT detection rates of organ injury and AAST grading with the two protocols were compared by McNemar test. Subjective analysis of image noise and artifacts and objective analysis of CT noise were performed by unpaired test. Compared with the routine-dose protocol, the low-dose protocol enabled an mean dose reduction of 59.8%. The detection rates and diagnostic performance of AAST grading did not differ significantly between the two protocols (detection rate, = 0.289; diagnostic performance, > 0.999). Objective image noise was significantly less with the low-dose protocol than with the routine-dose protocol ( < 0.001). Subjective imaging artifacts were similar between the low-dose and routine-dose protocols ( = 0.539). Compared with routine-dose protocol with FBP, low-dose CT with ASIR-V was useful for assessing multiorgan abdominal injury without impairing image quality.
本研究旨在评估和比较低剂量 CT 采用自适应统计迭代重建(ASIR-V)与常规剂量 CT 采用滤波反投影(FBP)在评估腹部器官损伤方面的诊断性能和图像质量。该研究纳入了 197 例创伤患者,他们接受了多期腹部 CT 检查,包括常规剂量门静脉期 FBP 成像和低剂量延迟期 50%ASIR-V 成像。回顾了腹部器官损伤(肝、脾、胰、肾)的存在情况,并根据美国外科创伤协会(AAST)量表对损伤进行分级。采用 McNemar 检验比较两种方案的器官损伤 CT 检出率和 AAST 分级,采用非配对 t 检验进行图像噪声和伪影的主观分析和 CT 噪声的客观分析。与常规剂量方案相比,低剂量方案的平均剂量降低了 59.8%。两种方案的检出率和 AAST 分级的诊断性能差异无统计学意义(检出率, = 0.289;诊断性能, > 0.999)。低剂量方案的客观图像噪声明显低于常规剂量方案( < 0.001)。低剂量方案和常规剂量方案的主观图像伪影相似( = 0.539)。与常规剂量 FBP 方案相比,低剂量 CT 联合 ASIR-V 可用于评估多器官腹部损伤,而不会降低图像质量。