在双层光谱探测器的脑计算机断层血管造影中使用8毫升碘化造影剂的可行性。
Feasibility of using 8 mL of iodinated contrast media in cerebral computed tomographic angiography with a dual-layer spectral detector.
作者信息
Leng Yinping, Liu Ying, Li Shuhao, Wang Xiwen, Deng Weiwei, Wang Yu, Gong Lianggeng
机构信息
Department of Radiology, the Second Affiliated Hospital of Nanchang University, Nanchang, China.
Clinical and Technical Support, Philips Healthcare, Shanghai, China.
出版信息
Quant Imaging Med Surg. 2024 Jan 3;14(1):514-526. doi: 10.21037/qims-23-914. Epub 2023 Dec 4.
BACKGROUND
Virtual monoenergetic images (VMIs) at a low energy level can improve image quality when the amount of iodinated contrast media (CM) is reduced. The purpose was to evaluate the feasibility of using an extremely low CM volume and injection rate in cerebral computed tomography angiography (CTA) on a dual-layer spectral detector computed tomography (CT).
METHODS
Patients who were clinically suspected of intracranial aneurysm or cerebrovascular diseases were included in our study (from June to November 2022). In this prospective study, 80 patients were randomly enrolled into group A (8 mL of CM with a 1-mL/s flow rate) or group B (40 mL of CM with 4-mL/s flow rate). The VMIs at 40-70 keV in group A and polychromatic conventional images in the 2 groups were reconstructed. CT attenuation, image noise, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were evaluated via the -test or Mann-Whitney test (2 groups), while analysis of variance or Kruskal-Wallis test (multiple groups). Subjective image quality was assessed on a 5-point scale.
RESULTS
In group A, the subjective image quality score, CT attenuation, and CNR of the internal carotid artery (ICA) and middle cerebral artery (MCA) were the highest on VMIs at 40 keV. The image noise on VMIs at 40 keV was 5.08±0.84 Hounsfield units. The subjective image quality score, CT value of the ICA, MCA, and cerebral parenchyma on VMIs at 40 keV in group A were similar to those in group B (all P values >0.05). Compared to those in group B, the VMIs at 40 keV in group A demonstrated a significantly higher mean SNR and CNR of the ICA (mean SNR: 46.22±20.18 34.32±12.40, P=0.002; CNR: 55.47±13.43 46.18±12.30, P=0.002) and MCA [SNR: 13.66 (9.78, 20.29) 9.99 (7.53, 14.00), P=0.003; CNR: 47.00±12.71 39.45±10.47, P=0.005].
CONCLUSIONS
Cerebral CTA on VMIs at 40 keV with 8 mL of CM and a 1-mL/s injection rate can provide diagnostic image quality.
背景
当减少碘对比剂（CM）用量时，低能量水平的虚拟单能图像（VMI）可改善图像质量。本研究旨在评估在双层光谱探测器计算机断层扫描（CT）上进行脑计算机断层血管造影（CTA）时使用极低CM用量和注射速率的可行性。
方法
纳入临床怀疑颅内动脉瘤或脑血管疾病的患者（2022年6月至11月）。在这项前瞻性研究中，80例患者被随机分为A组（8 mL CM，流速1 mL/s）或B组（40 mL CM，流速4 mL/s）。重建A组40 - 70 keV的VMI以及两组的多色常规图像。通过t检验或Mann-Whitney检验（两组）评估CT衰减、图像噪声、对比噪声比（CNR）和信噪比（SNR），而多组数据则采用方差分析或Kruskal-Wallis检验。主观图像质量采用5分制进行评估。
结果
在A组中，40 keV的VMI上颈内动脉（ICA）和大脑中动脉（MCA）的主观图像质量评分、CT衰减和CNR最高。40 keV的VMI上的图像噪声为5.08±0.84亨氏单位。A组40 keV的VMI上ICA、MCA和脑实质的主观图像质量评分、CT值与B组相似（所有P值>0.05）。与B组相比，A组40 keV的VMI显示ICA的平均SNR和CNR显著更高（平均SNR：46.22±20.18对34.32±12.40，P = 0.002；CNR：55.47±13.43对46.18±12.30，P = 0.002）以及MCA [SNR：13.66（9.78，20.29）对9.99（7.53，14.00），P = 0.003；CNR：47.00±12.71对39.45±10.47，P = 0.005]。
结论
使用8 mL CM和1 mL/s注射速率的40 keV的VMI进行脑CTA可提供诊断图像质量。
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