Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Skeletal Radiol. 2021 Jan;50(1):51-58. doi: 10.1007/s00256-020-03528-3. Epub 2020 Jun 29.
To determine the utility of iterative metal artifact reduction and 130 keV dual-energy virtual monoenergetic images to improve bone and soft tissue visualization in CT scans affected by metal artifacts.
Thirteen females and 6 males with a history of total shoulder prosthesis who underwent dual-energy shoulder CT were included. Four sets of images were reconstructed for each patient: (1) original polychromatic kV images reconstructed with weighted filtered back projection; (2) polychromatic kV images with iterative metal artifact reduction; (3) 130 keV dual-energy virtual monoenergetic; (4) combined iterative metal artifact reduction and 130 keV dual-energy virtual monoenergetic. Three readers blindly reviewed all image sets and graded the extent of artifact and image quality.
Mean artifact score and median overall image quality score were better in 130 keV dual-energy virtual monoenergetic with iterative metal artifact reduction compared with those in original polychromatic kV images (3.02 vs 4.28, P < 0.001 and 3.00 vs 4.33, P < 0.001, respectively). The median difference in CT numbers between regions affected by artifacts and normal regions was lowest in 130 keV dual-energy virtual monoenergetic with iterative metal artifact reduction compared with that in original polychromatic kV images (72.28 vs 252.08, P < 0.001 for bony regions and 15.09 vs 324.38, P < 0.001 for soft tissue).
In patients with metal artifacts due to shoulder replacement surgery, the use of dual-energy monoenergetic images and iterative metal artifact reduction reconstruction significantly improves both subjective and objective indicators of image quality.
确定迭代金属伪影减少和 130keV 双能虚拟单能量图像在改善受金属伪影影响的 CT 扫描中骨和软组织可视化的效果。
共纳入 13 名女性和 6 名男性，他们均有全肩关节假体置换病史并接受了双能肩部 CT 检查。为每位患者重建了四组图像：（1）原始多色 kV 图像，采用加权滤波反投影重建；（2）迭代金属伪影减少的多色 kV 图像；（3）130keV 双能虚拟单能量图像；（4）迭代金属伪影减少和 130keV 双能虚拟单能量图像的组合。三位读者盲法评估了所有图像组，并对伪影程度和图像质量进行评分。
与原始多色 kV 图像相比，迭代金属伪影减少的 130keV 双能虚拟单能量图像的平均伪影评分和总体图像质量评分中位数均更好（3.02 比 4.28，P<0.001 和 3.00 比 4.33，P<0.001）。受伪影影响的区域与正常区域之间的 CT 值中位数差异在迭代金属伪影减少的 130keV 双能虚拟单能量图像中最低，与原始多色 kV 图像相比（骨区域为 72.28 比 252.08，P<0.001，软组织为 15.09 比 324.38，P<0.001）。
在因肩部置换手术导致金属伪影的患者中，使用双能单能量图像和迭代金属伪影减少重建显著改善了图像质量的主观和客观指标。
