Elmokadem Ali H, Ibrahim Enas A, Gouda Walaa A, Khalek Abdel Razek Ahmed Abdel
From the Department of Radiology, Mansoura University, Dakahlia, Egypt.
Department of Radiology, Farwaniya Hospital, Sabah Al Nasser, Kuwait.
J Comput Assist Tomogr. 2019 Nov/Dec;43(6):870-876. doi: 10.1097/RCT.0000000000000907.
This study aimed to evaluate potential dose savings on a revised protocol for whole-body computed tomography and image quality after implementing Adaptive Statistical Iterative Reconstruction V (ASiR-V) algorism for trauma patients and compare it with routine protocol.
One hundred trauma patients were classified into 2 groups using 2 different scanning protocols. Group A (n = 50; age, 32.48 ± 8.09 years) underwent routine 3-phase protocol. Group B (n = 50; age, 35.94 ± 13.57 years) underwent biphasic injection protocol including unenhanced scan for the brain and cervical spines, followed by a 1-step acquisition of the thorax, abdomen, and pelvis. The ASiR-V level was kept at 50% for all examinations, and then studies were reconstructed at 0% ASiR-V level. Radiation dose, total acquisition time, and image count were compared between groups (A and B). Two radiologists independently graded image quality and artifacts between both groups and 2 ASiR-V levels (0 and 50%).
The mean (±SD) dose-length product value for postcontrast scans in group A was 1602.3 ± 271.8 mGy · cm and higher when compared with group B (P < 0.001), which was 951.1 ± 359.6 mGy · cm. Biphasic injection protocol gave a dose reduction of 40.4% and reduced the total acquisition time by 11.4% and image count by 37.6%. There was no statistically significant difference between the image quality scores for both groups; however, group A scored higher grades (4.62 ± 0.56 and 4.56 ± 0.67). Similarly, the image quality scores for both ASiR-V levels in both groups were not significantly different.
Biphasic computed tomography protocol reduced radiation dose with maintenance of diagnostic accuracy and image quality after implementing ASiR-V algorism.
本研究旨在评估对创伤患者实施自适应统计迭代重建V（ASiR-V）算法后，全身计算机断层扫描修订方案的潜在剂量节省情况及图像质量，并将其与常规方案进行比较。
100例创伤患者采用两种不同的扫描方案分为两组。A组（n = 50；年龄，32.48±8.09岁）采用常规三相方案。B组（n = 50；年龄，35.94±13.57岁）采用双相注射方案，包括对脑和颈椎进行平扫，随后一步采集胸部、腹部和骨盆。所有检查的ASiR-V水平保持在50%，然后在0% ASiR-V水平进行图像重建。比较A组和B组之间的辐射剂量、总采集时间和图像数量。两名放射科医生独立对两组以及两个ASiR-V水平（0和50%）之间的图像质量和伪影进行分级。
A组增强扫描后的平均（±标准差）剂量长度乘积值为1602.3±271.8 mGy·cm，高于B组（P < 0.001），B组为951.1±359.6 mGy·cm。双相注射方案使剂量降低了40.4%，总采集时间减少了11.4%，图像数量减少了37.6%。两组的图像质量评分之间无统计学显著差异；然而，A组评分更高（4.6 + 0.5 ± 0.67）。同样，两组中两个ASiR-V水平的图像质量评分也无显著差异。
双相计算机断层扫描方案在实施ASiR-V算法后降低了辐射剂量，同时保持了诊断准确性和图像质量。
