Department for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Department for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
J Neurointerv Surg. 2023 Mar;15(3):292-297. doi: 10.1136/neurintsurg-2021-018312. Epub 2022 Mar 22.
Flat detector computed tomography (FDCT) is widely used for periprocedural imaging in the angiography suite. Sine Spin FDCT (SFDCT) is the latest generation of cone beam CT using a double oblique trajectory for image acquisition to reduce artefacts and improve soft tissue brain imaging. This study compared the effective dose, image quality and diagnostic performance of the latest generation of SFDCT with multidetector CT (MDCT).
An anthropomorphic phantom equipped with MOSFET detectors was used to measure the effective dose of the new 7sDCT Sine Spin protocol on a latest generation biplane angiographic C-arm system. Diagnostic performance was evaluated on periprocedurally acquired SFDCT for depiction of anatomical details, detection of hemorrhage, and ischemia and was compared with preprocedurally acquired MDCT. Inter- and intra-rater correlation as well as sensitivity and specificity were calculated.
Both modalities showed equal diagnostic performance in the supratentorial ventricular system. SFDCT provided inferior image quality in grey-white matter differentiation and infratentorial structures. Intraventricular, subarachnoid and parenchymal hemorrhages were diagnosed with a sensitivity of 83.3%, 84.2% and 75% and a specificity of 97.3%, 80.0% and 100%, respectively; early ischemic lesions with a sensitivity of 73.3% and specificity 94.7%. The effective dose measured for the 7sDCT Sine Spin protocol was 2 mSv.
Our findings confirm the high diagnostic sensitivity and specificity of SFDCT in detecting intracranial hemorrhage and early ischemic lesions. The delineation of grey-white matter differentiation and infratentorial structures remains a limiting factor. In comparison to previous studies, the new 7sDCT Sine Spin protocol showed a lower effective dose.
平板探测器计算机断层扫描(FDCT)广泛应用于血管造影室的围手术期成像。正弦旋转 FDCT(SFDCT)是最新一代的锥形束 CT,采用双斜轨迹进行图像采集,以减少伪影并改善软组织脑成像。本研究比较了最新一代 SFDCT 与多排 CT(MDCT)的有效剂量、图像质量和诊断性能。
使用配备 MOSFET 探测器的人体模型来测量最新一代双平面血管造影 C 臂系统上 7sDCT 正弦旋转协议的有效剂量。在围手术期获取的 SFDCT 上评估诊断性能,以描绘解剖细节、检测出血和缺血,并与术前获取的 MDCT 进行比较。计算了组内和组间的相关性以及敏感性和特异性。
两种模式在幕上脑室系统均具有相同的诊断性能。SFDCT 在灰白质区分和幕下结构方面提供了较差的图像质量。脑室、蛛网膜下腔和脑实质出血的诊断敏感性分别为 83.3%、84.2%和 75%,特异性分别为 97.3%、80.0%和 100%;早期缺血性病变的敏感性为 73.3%,特异性为 94.7%。7sDCT 正弦旋转协议的有效剂量为 2mSv。
我们的研究结果证实了 SFDCT 在检测颅内出血和早期缺血性病变方面具有高诊断敏感性和特异性。灰-白质区分和幕下结构的描绘仍然是一个限制因素。与以前的研究相比,新的 7sDCT 正弦旋转协议显示出较低的有效剂量。