[CT金属伪影校正技术（MAC）在全髋关节置换术后CT复查中的应用价值]
[Application Value of CT Metal Artifact Correction Technology (MAC ) in CT Review after Total Hip Replacement].
作者信息
Yang Fan, Liang Yi-Wen, Shao Qiang, Li Chen-Wei, Yuan Yuan, Pan Xue-Lin, Li Zhen-Lin
机构信息
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Medical Imaging Technology, West China School of Medcine, Sichuan University, Chengdu 610041, China.
出版信息
Sichuan Da Xue Xue Bao Yi Xue Ban. 2020 Nov;51(6):828-833. doi: 10.12182/20201160603.
OBJECTIVE
To evaluate the application value of CT metal artifact correction technology (MAC ) in CT review after total hip replacement.
METHODS
A total of 72 patients who underwent CT re-examination after total hip replacement from December 2018 to March 2020 were enrolled, and the original data were reconstructed by filter backup projection （FBP） and MAC. Select three identical levels in the two sets of reconstructed images and place the same ROI. The selected levels were the initial level, central level, and lower edge of acetabulum. Measure the CT and noise (SD) of metal high and low density artifacts of the three levels area, as well as metal hip joint space, metal para-bone tissue, muscle, bladder and subcutaneous fat, and calculate the average value. Subcutaneous fat value was used as a reference to calculate the SNR and CNR of metal implant para-bone tissue, muscle and bladder. Two radiologists scored the two groups of reconstructed images using blinded method, Kappa's test was used to compare the homogeneity.
RESULTS
There were differences between the two groups of reconstructed images in high- and low-density artifact areas, joint gap CT values, and image noise. Compared with the FBP group, the CT value of the high-density area and the joint space of the MAC group decreased, the CT value of the low-density area increased, and the noise value of each area decreased. The SNR and CNR of metal adjacent bone tissue, muscle and bladder were higher in the MAC group than those in the FBP group, and the difference was statistically significant ( <0.05). The difference in subjective scores between the two groups was statistically significant ( =-6.564, <0.05). 2 radiologists had moderate consistency with Kappa value of 0.72 on FBP group, and good consistency with Kappa value of 0.85 on MAC group.
CONCLUSION
MAC in CT review after total hip replacement can reduce metal artifacts, make the joint space more clear, and improve the quality of CT images.
目的
评估CT金属伪影校正技术（MAC）在全髋关节置换术后CT复查中的应用价值。
方法
选取2018年12月至2020年3月期间行全髋关节置换术后CT复查的72例患者，对原始数据分别采用滤波反投影（FBP）和MAC进行重建。在两组重建图像中选取三个相同层面并放置相同的感兴趣区（ROI）。所选层面为起始层面、中间层面及髋臼下缘。测量三个层面区域金属高低密度伪影的CT值及噪声（SD），以及金属髋关节间隙、金属旁骨组织、肌肉、膀胱及皮下脂肪，并计算平均值。以皮下脂肪值为参照，计算金属植入物旁骨组织、肌肉及膀胱的信噪比（SNR）和对比噪声比（CNR）。两名放射科医师采用盲法对两组重建图像进行评分，采用Kappa检验比较一致性。
结果
两组重建图像在高低密度伪影区域、关节间隙CT值及图像噪声方面存在差异。与FBP组相比，MAC组高密度区域及关节间隙的CT值降低，低密度区域的CT值升高，各区域的噪声值降低。MAC组金属相邻骨组织、肌肉及膀胱的SNR和CNR高于FBP组，差异有统计学意义（<0.05）。两组主观评分差异有统计学意义（=-6.564，<0.05）。两名放射科医师对FBP组的一致性为中等，Kappa值为0.72，对MAC组的一致性良好，Kappa值为0.85。
结论
全髋关节置换术后CT复查中应用MAC可减少金属伪影，使关节间隙更清晰，提高CT图像质量。
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