Department of Diagnostic and Interventional Radiology, MHH, Hannover, Germany.
Clinic for Pneumology, MHH, Hannover, Germany.
Rofo. 2021 Sep;193(9):1074-1080. doi: 10.1055/a-1354-6736. Epub 2021 Feb 25.
To evaluate the feasibility and image quality of a motion correction algorithm for supra-selective C-arm computed tomography (CACT) of the pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).
MATERIALS & METHODS: CACT raw data acquired during 30 consecutive BPAs were used for image reconstruction using either standard (CACTorg) or a motion correction algorithm (CACTmc), using 400 iterations. Two readers independently evaluated 188 segmental and 564 sub-segmental contrast-enhanced pulmonary arteries in each reconstruction. The following categories were assessed: Sharpness of the vessel, motion artifacts, delineation of bronchial structures, vessel geometry, and visibility of treatable lesions. The mentioned criteria were rated from grade 1 to grade 3: grade 1: excellent quality; grade 2: good quality; grade 3: poor/seriously impaired quality. Inter-observer agreement was calculated using Cohen's Kappa. Due to an excellent agreement, the ratings of both readers were merged. Differences in the assessed image quality criteria were evaluated using pairwise Wilcoxon signed-rank test.
Inter-observer agreement was excellent for all evaluated image quality criteria (κ > 0.81). For all assessed image quality criteria, the ratings on CACTorg were good but improved significantly for CACTmc to excellent for the whole vascular tree (p < 0.01). When considering segmental and sub-segmental levels individually, all image quality criteria improved significantly for CACTmc on both levels (p < 0.01). While ratings of CACTmc were constant for both levels (segmental and sub-segmental) for all criteria, the ratings of CACTorg were slightly impaired for the sub-segmental arteries.
Motion correction for supra-selective contrast-enhanced CACT of the pulmonary arteries is feasible and improves the overall image quality.
· Motion artifacts can severely impair the diagnostic accuracy of CACT.. · A motion correction algorithm can significantly improve image quality in CACT of the pulmonary arteries.. · Especially the overall image quality of sub-segmental branches is significantly improved..
· Maschke S, Werncke T, Becker LS et al. Motion Reduction for C-Arm Computed Tomography of the Pulmonary Arteries: Image Quality of a Motion Correction Algorithm in Patients with Chronic Thromboembolic Hypertension During Balloon Pulmonary Angioplasty. Fortschr Röntgenstr 2021; 193: 1074 - 1080.
评估在接受球囊肺动脉成形术 (BPA) 的慢性血栓栓塞性肺动脉高压 (CTEPH) 患者中，对肺动脉进行超选择性 C 臂计算机断层扫描 (CACT) 的运动校正算法的可行性和图像质量。
使用 400 次迭代，对 30 次连续 BPA 过程中采集的 CACT 原始数据分别进行标准重建 (CACTorg) 或运动校正算法重建 (CACTmc)，并由两位读者分别对每个重建的 188 个节段性和 564 个亚节段性增强肺动脉进行评估。评估了以下类别：血管锐利度、运动伪影、支气管结构勾画、血管几何形状和可治疗病变的显示。使用等级 1 到 3 对这些标准进行评级：1 级：极好的质量；2 级：良好的质量；3 级：差/严重受损的质量。使用 Cohen's Kappa 计算观察者间的一致性。由于极好的一致性，将两位读者的评分合并。使用配对 Wilcoxon 符号秩检验评估评估图像质量标准的差异。
对于所有评估的图像质量标准，观察者间的一致性均极好 (κ>0.81)。对于所有评估的图像质量标准，CACTorg 的评分均为良好，但使用 CACTmc 重建后，整个血管树的评分显著提高至优秀 (p<0.01)。当单独考虑节段性和亚节段性水平时，两种方法在两个水平上的所有图像质量标准均显著提高 (p<0.01)。尽管 CACTmc 的评分在两个水平 (节段性和亚节段性) 的所有标准上保持不变，但 CACTorg 的评分在亚节段性动脉上略有下降。
超选择性增强 CACT 肺动脉的运动校正具有可行性，并可提高整体图像质量。
·运动伪影会严重影响 CACT 的诊断准确性。·运动校正算法可显著提高肺动脉 CACT 的图像质量。·特别是亚节段分支的整体图像质量得到了显著改善。
