胸部成像中注射造影剂后的CT伪影：后处理算法、虚拟单能图像及其组合用于减少伪影的评估
CT artifacts after contrast media injection in chest imaging: evaluation of post-processing algorithms, virtual monoenergetic images and their combination for artifact reduction.
作者信息
Gupta Amit, Obmann Verena Carola, Jordan Michelle, Lennartz Simon, Obmann Markus Michael, Große Hokamp Nils, Zopfs David, Pennig Lenhard, Fürtjes Gina, Ramaiya Nikhil, Gilkeson Robert, Laukamp Kai Roman
机构信息
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Department of Radiology, Case Western Reserve University, Cleveland, OH, USA.
出版信息
Quant Imaging Med Surg. 2021 Jan;11(1):226-239. doi: 10.21037/qims-20-435.
BACKGROUND
After injection into a brachial vein, high contrast media concentration in axillary and subclavian veins can cause artifacts that impair diagnostic utility. This study assessed artifact reduction by artifact-reduction-algorithms (ARA) and virtual-monoenergetic-images (VMI), as well as their combination (VMI) compared to conventional CT-images (CI).
METHODS
Forty-six spectral-detector-CT (SDCT) examinations of patients that received ARA-reconstructions due to perivenous-artifacts were included in this retrospective study. CI, ARA, VMI, and VMI (range: 70-200 keV) were reconstructed. Objective analysis was performed with ROI-based assessment of mean and standard deviation of attenuation (HU) in hypo- and hyperdense artifacts and impaired muscle and arteries as well as artifact-free reference-tissue. Extent of artifact reduction, assessment of surrounding soft tissue and vessels, and appearance of new artifacts were rated visually by two radiologists.
RESULTS
Hypo- and hyperdense artifacts showed significant improvement as evidenced by decreasing attenuation differences between artifact impaired and artifact-free reference tissue in ARA, VMI ≥80 keV, and VMI between 70-200 keV (e.g., CI/ARA/VMI/VMI: hypodense artifacts, (-)264.8±150.9/(-)87.1±78.9/(-)48.6±64.6/9.9±63.9 HU; P<0.001); hyperdense artifacts, 164.2±51.1/82.1±73.2/7.9±34.7/(-)17.3±50.7 HU; P<0.001). Artifacts impairing surrounding muscle and arteries were also reduced by all three approaches. In visual assessment, ARA, VMI ≥100 keV, and VMI between 70-200 keV also showed significant artifact reduction and improved assessment; however, for assessment of arteries improvement was not significant using ARA alone. New artifacts were reported, particularly at higher keV-values.
CONCLUSIONS
In presence of perivenous-artifacts, ARA, VMI and their combination allow for significant artifact reduction; however, their combination and VMI as a standalone approach yielded best results and should therefore be used, if available.
背景
将造影剂注入肱静脉后，腋窝和锁骨下静脉内的高造影剂浓度可导致伪影，从而影响诊断效果。本研究评估了伪影减少算法（ARA）和虚拟单能图像（VMI）以及它们的组合（VMI）与传统CT图像（CI）相比对伪影的减少情况。
方法
本回顾性研究纳入了46例因静脉周围伪影接受ARA重建的患者的光谱探测器CT（SDCT）检查。重建了CI、ARA、VMI和VMI（范围：70 - 200 keV）。通过基于感兴趣区（ROI）评估低密度和高密度伪影、受损肌肉和动脉以及无伪影参考组织中的衰减（HU）均值和标准差进行客观分析。由两名放射科医生对伪影减少程度、周围软组织和血管的评估以及新伪影的出现情况进行视觉评分。
结果
低密度和高密度伪影均有显著改善，这可通过ARA、VMI≥80 keV以及70 - 200 keV之间的VMI中伪影受损组织与无伪影参考组织之间的衰减差异减小得到证明（例如，CI/ARA/VMI/VMI：低密度伪影，(-)264.8±150.9/(-)87.1±78.9/(-)48.6±64.6/9.9±63.9 HU；P<0.001）；高密度伪影，164.2±51.1/82.1±73.2/7.9±34.7/(-)17.3±50.7 HU；P<0.001）。所有三种方法也都减少了损害周围肌肉和动脉的伪影。在视觉评估中，ARA、VMI≥100 keV以及70 - 200 keV之间的VMI也显示出伪影显著减少且评估得到改善；然而，单独使用ARA评估动脉时改善并不显著。报告了新的伪影，尤其是在较高keV值时。
结论
在存在静脉周围伪影的情况下，ARA、VMI及其组合可显著减少伪影；然而，它们的组合以及单独使用VMI产生的效果最佳，因此如果可行应予以使用。
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