使用超高分辨率双源光子计数探测器计算机断层扫描对冠状动脉节段进行图像质量评估。

Image quality assessment of coronary artery segments using ultra-high resolution dual source photon-counting detector computed tomography.

作者信息

van der Bie Judith, Sharma Simran P, van Straten Marcel, Hirsch Alexander, Kamila Putri Annisa, Bos Daniel, Dijkshoorn Marcel L, Booij Ronald, Budde Ricardo P J

机构信息

Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

出版信息

Eur J Radiol. 2024 Feb;171:111282. doi: 10.1016/j.ejrad.2023.111282. Epub 2024 Jan 3.

DOI:10.1016/j.ejrad.2023.111282

PMID:38190778

Abstract

PURPOSE

The study is intended to assess the image quality of ultra-high resolution (UHR) coronary computed tomography angiography (CCTA) performed on dual source photon-counting detector CT (PCD-CT).

METHOD

Consecutive patients, who underwent clinically indicated CCTA on PCD-CT (UHR 120x 0.2 mm collimation), were included. CCTA images were reconstructed at 0.2 mm slice thickness with Bv40, Bv44, Bv48 and Bv56 kernels and quantum iterative reconstruction level 4. Contrast-to-noise (CNR) and signal-to-noise ratios (SNR) were quantified from contrast-enhanced blood and subcutaneous adipose tissue. All reconstructions were scored per coronary segment (18-segment model) for presence, image quality, motion artefacts, stack artefacts, plaque presence and composition, and stenosis degree. Image quality was scored by two independent observers.

RESULTS

Sixty patients were included (median age 62 [25th 75th percentile: 53-67] years, 45% male, median calcium score 62 [0-217]). The mean heart rate during scanning was 71 ± 11 bpm. Median CTDIvol was 19 [16-22]mGy and median DLP 243 [198-327]mGy.cm. The SNR was 9.3 ± 2.3 and the CNR was 11.7 ± 2.6. Of the potential 1080 coronary segments (60 patients x 18 segments), 255/256 (reader1/reader2) segments could not be assessed for being absent or non-evaluable due to size. Both readers scored 85% of the segments as excellent or very good (Intraclass Correlation Coefficient: 0.88 (95% CI: 0.87-0.90). Motion artefacts were present in 45(5%) segments, stack artefacts in 60(7%) segments and metal artefacts in 9(1%) segments.

CONCLUSION

UHR dual-source PCD-CT CCTA provides excellent or very good image quality in 85% of coronary segments at relatively high heart rates at moderate radiation dose with only limited stack artefacts.

摘要

目的

本研究旨在评估在双源光子计数探测器CT（PCD-CT）上进行的超高分辨率（UHR）冠状动脉计算机断层扫描血管造影（CCTA）的图像质量。

方法

纳入连续接受PCD-CT（UHR 120×0.2mm准直）上临床指征的CCTA检查的患者。CCTA图像以0.2mm层厚，使用Bv40、Bv44、Bv48和Bv56内核以及量子迭代重建水平4进行重建。从增强对比的血液和皮下脂肪组织中量化对比噪声比（CNR）和信噪比（SNR）。对所有重建图像按照冠状动脉节段（18节段模型）进行评分，评估节段的存在情况、图像质量、运动伪影、层叠伪影、斑块的存在及成分以及狭窄程度。图像质量由两名独立观察者进行评分。

结果

纳入60例患者（年龄中位数62岁[第25至75百分位数：53 - 67岁]，男性占45%，钙评分中位数62[0 - 217]）。扫描期间平均心率为71±11次/分钟。CTDIvol中位数为19[16 - 22]mGy，DLP中位数为243[198 - 327]mGy·cm。SNR为9.3±2.3，CNR为11.7±2.6。在潜在的1080个冠状动脉节段（60例患者×18个节段）中，255/256（读者1/读者2）个节段因尺寸过小无法评估其是否存在或不可评估。两名读者均将85%的节段评为优秀或非常好（组内相关系数：0.88（95%CI：0.87 - 0.90））。45（5%）个节段存在运动伪影，60（7%）个节段存在层叠伪影，9（1%）个节段存在金属伪影。