Graduate School of Biomedical Engineering, Yonsei University College of Medicine, Seoul, Korea.
CONNECT-AI R&D Center, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2021 Mar;62(3):200-208. doi: 10.3349/ymj.2021.62.3.200.
To compare image quality in selective intracoronary contrast-injected computed tomography angiography (Selective-CTA) with that in conventional intravenous contrast-injected CTA (IV-CTA).
Six pigs (35 to 40 kg) underwent both IV-CTA using an intravenous injection (60 mL) and Selective-CTA using an intracoronary injection (20 mL) through a guide-wire during/after percutaneous coronary intervention. Images of the common coronary artery were acquired. Scans were performed using a combined machine comprising an invasive coronary angiography suite and a 320-channel multi-slice CT scanner. Quantitative image quality parameters of CT attenuation, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), mean lumen diameter (MLD), and mean lumen area (MLA) were measured and compared. Qualitative analysis was performed using intraclass correlation coefficient (ICC), which was calculated for analysis of interobserver agreement.
Quantitative image quality, determined by assessing the uniformity of CT attenuation (399.06 vs. 330.21, <0.001), image noise (24.93 vs. 18.43, <0.001), SNR (16.43 vs. 18.52, =0.005), and CNR (11.56 vs. 13.46, =0.002), differed significantly between IV-CTA and Selective-CTA. MLD and MLA showed no significant difference overall (2.38 vs. 2.44, =0.068, 4.72 vs. 4.95, =0.078). The density of contrast agent was significantly lower for selective-CTA (13.13 mg/mL) than for IV-CTA (400 mg/mL). Agreement between observers was acceptable (ICC=0.79±0.08).
Our feasibility study in swine showed that compared to IV-CTA, Selective-CTA provides better image quality and requires less iodine contrast medium.
比较选择性冠状动脉内对比增强计算机断层血管造影术（选择性 CTA）与常规静脉内对比增强计算机断层血管造影术（IV-CTA）的图像质量。
6 只猪（35 至 40 千克）在经皮冠状动脉介入治疗期间/之后通过导丝分别进行 IV-CTA（静脉注射 60mL）和选择性 CTA（冠状动脉内注射 20mL）。采集到的是共同冠状动脉图像。扫描是使用一台集侵入性冠状动脉造影套件和一台 320 通道多层 CT 扫描仪的联合机进行的。对 CT 衰减、图像噪声、信噪比（SNR）、对比噪声比（CNR）、平均管腔直径（MLD）和平均管腔面积（MLA）等定量图像质量参数进行测量并比较。使用组内相关系数（ICC）进行定性分析，ICC 用于分析观察者间的一致性。
通过评估 CT 衰减均匀性（399.06 对 330.21，<0.001）、图像噪声（24.93 对 18.43，<0.001）、SNR（16.43 对 18.52，=0.005）和 CNR（11.56 对 13.46，=0.002），IV-CTA 和选择性 CTA 的定量图像质量存在显著差异。总体而言，MLD 和 MLA 无显著差异（2.38 对 2.44，=0.068，4.72 对 4.95，=0.078）。选择性 CTA 中的造影剂密度（13.13mg/mL）明显低于 IV-CTA（400mg/mL）。观察者之间的一致性是可以接受的（ICC=0.79±0.08）。
我们在猪身上进行的可行性研究表明，与 IV-CTA 相比，选择性 CTA 提供更好的图像质量，并且需要更少的碘造影剂。
