CT灌注衍生CT血管造影与传统CT血管造影的图像质量和诊断性能比较。
The image quality and diagnostic performance of CT perfusion-derived CT angiography versus that of conventional CT angiography.
作者信息
Zhou Xiu-Zhi, Lu Kuan, Zhai Du-Chang, Cui Man-Man, Liu Yan, Wang Ting-Ting, Shi Dai, Fan Guo-Hua, Ju Sheng-Hong, Cai Wu
机构信息
Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China.
出版信息
Quant Imaging Med Surg. 2023 Oct 1;13(10):7294-7303. doi: 10.21037/qims-22-988. Epub 2023 Jul 20.
BACKGROUND
The combination of computed tomography angiography (CTA) and computed tomography perfusion (CTP) evaluation of cerebral perfusion status and vascular conditions can improve the diagnostic accuracy of infarction, ischemia, and vascular occlusion in stroke patients, as well as a comprehensive assessment of cerebral edema, collateral circulation, and blood perfusion in the lesion area. However, the consequent radiation safety and contrast agent nephropathy have aroused increasing concern. The purpose of this study was to assess the image quality and diagnostic accuracy of CTA images derived from CTP data, and to explore the feasibility of replacing conventional CTA.
METHODS
A total of 31 consecutive patients with suspected acute ischemic stroke were retrospectively analyzed. All patients underwent head and neck CTA and brain CTP examinations. All the CTP images were transmitted to the ShuKun artificial intelligence system, which reconstructs CTA derived from CTP (CTA-DF-CTP). The images were divided into 2 groups, including CTA-DF-CTP (Group A) and conventional CTA (Group B). The CT attenuation values, subjective image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality, CT volume dose index (CTDIvol), dose length product (DLP), and effective radiation dose (ED) were compared between the 2 groups. Moreover, the consistency of vascular stenosis and stenosis degree between the 2 groups were measured and evaluated.
RESULTS
There were no significant differences in image noise, SNR, or CNR between Groups A and B (P>0.05). The CT attenuation values of the arteries were higher in Group A than in B [internal carotid artery (ICA) =548±112 454±85 Hounsfield units (HU), middle cerebral artery (MCA) =453±118 388±70 HU, and basilar artery (BA) =431±99 360±83 HU] (P<0.01). The image quality of the 2 groups met the requirement of clinical diagnosis (4.97±0.18 4.94±0.25). No significant difference was found in subjective evaluation (P>0.05). In Group A compared with Group B, the following reductions were observed: CTDIvol (10.7%; 100.8 112.9 mGy), DLP (23.0%; 1,613±0 2,093±88 mGy·cm), and ED (23.0%; 5.00±0.00 6.49±0.27 mSv).
CONCLUSIONS
CTA-DF-CTP data provide diagnostic accuracy and image quality similar to those of conventional CTA of head and neck CTA.
背景
计算机断层血管造影（CTA）与计算机断层灌注（CTP）相结合评估脑灌注状态和血管情况，可提高脑卒中患者梗死、缺血及血管闭塞的诊断准确性，以及对病变区域脑水肿、侧支循环和血液灌注的综合评估。然而，随之而来的辐射安全和造影剂肾病问题日益受到关注。本研究旨在评估从CTP数据中获取的CTA图像的图像质量和诊断准确性，并探讨替代传统CTA的可行性。
方法
回顾性分析31例连续的疑似急性缺血性脑卒中患者。所有患者均接受头颈部CTA和脑部CTP检查。所有CTP图像均传输至术康人工智能系统，该系统可重建源自CTP的CTA（CTA-DF-CTP）。图像分为2组，包括CTA-DF-CTP（A组）和传统CTA（B组）。比较两组之间的CT衰减值、主观图像噪声、信噪比（SNR）、对比噪声比（CNR）、图像质量、CT容积剂量指数（CTDIvol）、剂量长度乘积（DLP）和有效辐射剂量（ED）。此外，测量并评估两组之间血管狭窄及狭窄程度的一致性。
结果
A组和B组在图像噪声、SNR或CNR方面无显著差异（P>0.05）。A组动脉的CT衰减值高于B组[颈内动脉（ICA）=548±112对454±85亨氏单位（HU），大脑中动脉（MCA）=453±118对388±70 HU，基底动脉（BA）=431±99对360±83 HU]（P<0.01）。两组的图像质量均符合临床诊断要求（4.97±0.18对4.94±0.25）。主观评估未发现显著差异（P>0.05）。与B组相比，A组观察到以下降低情况：CTDIvol（10.7%；100.8对112.9 mGy），DLP（23.0%；1613±0对2093±88 mGy·cm），以及ED（23.0%；5.00±0.00对6.49±0.27 mSv）。
结论
CTA-DF-CTP数据提供的诊断准确性和图像质量与头颈部CTA的传统CTA相似。
Zotero 插件