Wei Y J, Wang X P, Zha K J, Gao J B
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2021 Mar 30;101(12):841-845. doi: 10.3760/cma.j.cn112137-20210110-00069.
To investigate the effect of multi-material artifact reduction (MMAR) technique on the maxillofacial CT images of patients with metallic dental implants. The data of 30 patients with metal denture implants who underwent maxillofacial wide-detector CT scans in the Department of Radiology of the First Affiliated Hospital of Zhengzhou University from March 2019 to February 2020 were retrospectively collected. The images of the lesion sites of patients were all affected by the metal implants artifacts. The 120 kV-like, virtual monoenergetic images (VMI) (70, 90, 110 keV), VMI (70, 90, 110 keV)+MMAR images were reconstructed at venous phase by energy spectrum scanning. A total of 7 image sequences were obtained for each patient. The CT value and noise value of the lesion and the longus capitis muscle on the same plane were measured, and the artifact index (AI) of lesion was calculated.Friedman test and Wilcoxon test were used to evaluate image quality objectively and subjectively. There were significant differences in SD and AI among the 7 groups (=133.800,<0.001;=92.147,<0.001). The SD[10 (8, 12)] and AI [6 (5, 9)]of VMI 110 keV+M images were the lowest, but there were no significant differences in AI between VMI 110 keV+M and VMI 90 keV+M image (= 0.271). The SD and AI of VMI+M group were lower than those in VMI group (all <0.05). There was significant difference in image score among the 7 groups ( = 151.199, <0.001). The image scores of VMI (70, 90, 110 keV)+M group were higher than those of VMI group (=-4.583, = 0.000; =-3.742, = 0.000; =-2.449, = 0.014). The subjective score of VMI 90 keV+M [4 (3, 4)] was the highest, higher than those of other 6 groups (all <0.05), in 26 out of 30 cases, lesions displayed clear contrast, and the artifacts eliminated completely. The MMAR technique of wide-detector CT might effectively remove the metallic dental implants artifacts and improve the image quality. VMI 90 keV+MMAR images could achieve the best artifact removal effect and good tissue contrast.
探讨多材料伪影减少(MMAR)技术对金属牙种植体患者颌面CT图像的影响。回顾性收集2019年3月至2020年2月在郑州大学第一附属医院放射科接受颌面宽探测器CT扫描的30例金属假牙种植体患者的数据。患者病变部位的图像均受金属植入物伪影影响。通过能谱扫描在静脉期重建120 kV类似图像、虚拟单能图像(VMI)(70、90、110 keV)、VMI(70、90、110 keV)+MMAR图像。每位患者共获得7个图像序列。测量同一平面上病变及头长肌的CT值和噪声值,并计算病变的伪影指数(AI)。采用Friedman检验和Wilcoxon检验对图像质量进行客观和主观评价。7组间标准差(SD)和AI差异有统计学意义(=133.800,<0.001;=92.147,<0.001)。VMI 110 keV+M图像的SD[10(8,12)]和AI[6(5,9)]最低,但VMI 110 keV+M与VMI 90 keV+M图像的AI差异无统计学意义(=0.271)。VMI+M组的SD和AI低于VMI组(均<0.05)。7组间图像评分差异有统计学意义(=151.199,<0.001)。VMI(70、90、110 keV)+M组的图像评分高于VMI组(=-4.583,=0.000;=-3.742,=0.000;=-2.449,=0.014)。VMI 90 keV+M的主观评分[4(3,4)]最高,高于其他6组(均<0.05),30例中有26例病变显示对比清晰,伪影完全消除。宽探测器CT的MMAR技术可有效去除金属牙种植体伪影,提高图像质量。VMI 90 keV+MMAR图像可获得最佳伪影去除效果和良好的组织对比度。