Department of Pediatrics, Pusan National University Children's Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea.
Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea.
Sci Rep. 2022 Feb 9;12(1):2147. doi: 10.1038/s41598-022-06246-z.
This study assessed the image quality and diagnostic accuracy in determining disease activity of the terminal ileum of the reduced-dose computed tomography enterography using model-based iterative reconstruction in pediatric patients with Crohn's disease (CD). Eighteen patients were prospectively enrolled and allocated to the standard-dose (SD) and reduced-dose (RD) computed tomography enterography (CTE) groups (n = 9 per group). Image quality, reader confidence in interpreting bowel findings, accuracy in determining active CD in the terminal ileum, and radiation dose were evaluated. Objective image quality did not show intergroup differences, except for image sharpness. Although reader confidence in detecting mural stratification, ulcer, and perienteric fat stranding of the RD-CTE were inferior to SD-CTE, RD-CTE correctly diagnosed active disease in all patients. The mean values of radiation dose metrics (SD-CTE vs. RD-CTE) were 4.3 versus 0.74 mGy, 6.1 versus 1.1 mGy, 211.9 versus 34.5 mGy∙cm, and 4.4 versus 0.7 mSv mGy∙cm for CTDI, size-specific dose estimation, dose-length product, and effective dose, respectively. RD-CTE showed comparable diagnostic accuracy to SD-CTE in determining active disease of the terminal ileum in pediatric CD patients. However, image quality and reader confidence in detecting ulcer and perienteric fat stranding was compromised.
本研究评估了基于模型的迭代重建在儿童克罗恩病（CD）患者中降低剂量 CT 肠造影术对末端回肠疾病活动度的诊断准确性和图像质量。18 名患者前瞻性入组并分为标准剂量（SD）和低剂量（RD）CT 肠造影术（CTE）组（每组 n=9）。评估了图像质量、读者对肠内发现的解释信心、确定末端回肠活动性 CD 的准确性和辐射剂量。客观图像质量没有显示出组间差异，除了图像清晰度。尽管 RD-CTE 检测壁层分层、溃疡和肠周脂肪条纹的读者信心低于 SD-CTE，但 RD-CTE 正确诊断了所有患者的活动性疾病。辐射剂量指标的平均值（SD-CTE 与 RD-CTE）分别为 4.3 与 0.74 mGy、6.1 与 1.1 mGy、211.9 与 34.5 mGy·cm 和 4.4 与 0.7 mSv·mGy·cm，用于 CTDI、体型特异性剂量估计、剂量长度乘积和有效剂量。RD-CTE 在确定儿科 CD 患者末端回肠活动性疾病方面与 SD-CTE 具有相当的诊断准确性。然而，图像质量和读者对溃疡和肠周脂肪条纹的检测信心受到影响。
