Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Clin Radiol. 2024 Oct;79(10):e1260-e1267. doi: 10.1016/j.crad.2024.07.002. Epub 2024 Jul 9.
This study aimed to investigate the utility of low-energy virtual monochromatic imaging (VMI) combined with deep-learning image reconstruction (DLIR) in improving the delineation of endoleaks (ELs) after endovascular aortic repair (EVAR) in contrast-enhanced dual-energy CT (DECT).
A total of 61 consecutive patients (mean age, 77 years; 46 men) after EVAR who underwent contrast-enhanced DECT were enrolled. Virtual monochromatic 40- and 70-keV images were reconstructed using DLIR (TrueFidelity-H) and conventional hybrid iterative reconstruction (IR). Contrast-to-noise ratio (CNR) of the EL on the venous-phase CT was calculated. Four different reconstructed image series (hybrid IR and DLIR at two energy levels, 40- and 70-keV) were displayed side-by-side and visually assessed for EL conspicuity on a 5-point comparative scale from 0 (best) to -4 (significantly inferior). Two experienced radiologists independently conducted a qualitative evaluation of the CT images.
A total of 30 out of 61 patients presented with an EL. On both 40- and 70-keV images, the CNR of the EL was significantly higher in DLIR than in hybrid IR (40-keV, 14.5 ± 7.3 vs 8.6 ± 4.2, P<0.001; 70-keV, 8.7 ± 4.5 vs 5.5 ± 2.6, P<0.001). The comparative scale of EL conspicuity in the 40-keV DLIR images (Observer1, -0.2 ± 0.4; Observer2, 0.0 ± 0.0) was significantly higher than 40-keV hybrid IR (Observer1, -0.5 ± 0.5; Observer2, -1.0 ± 0.0; P<0.05), 70-keV DLIR (Observer1, -1.8 ± 0.4; Observer2, -2.0 ± 0.0; P<0.001) and 70-keV hybrid IR images (Observer1, -1.8 ± 0.4; Observer2, -2.4 ± 0.5; P<0.001), respectively.
Using 40-keV VMI in combination with DLIR improves EL delineation after EVAR compared with the 70-keV VMI with hybrid IR or DLIR.
本研究旨在探讨低能量虚拟单色成像（VMI）联合深度学习图像重建（DLIR）在增强对比双能 CT（DECT）后血管内修复（EVAR）后内漏（EL）描绘中的应用价值。
共纳入 61 例 EVAR 后行增强 DECT 的连续患者（平均年龄 77 岁；46 例男性）。使用 DLIR（TrueFidelity-H）和常规混合迭代重建（IR）对虚拟单色 40keV 和 70keV 图像进行重建。计算静脉期 CT 上 EL 的对比噪声比（CNR）。并排显示四种不同的重建图像系列（两种能量水平的混合 IR 和 DLIR，40keV 和 70keV），并使用 0（最佳）至-4（明显较差）的 5 分比较量表对 EL 显影进行视觉评估。两位有经验的放射科医生独立对 CT 图像进行了定性评估。
共有 30 例患者存在 EL。在 40keV 和 70keV 图像上，EL 的 CNR 在 DLIR 中均明显高于混合 IR（40keV，14.5±7.3 比 8.6±4.2，P<0.001；70keV，8.7±4.5 比 5.5±2.6，P<0.001）。40keV DLIR 图像中 EL 显影的比较量表（观察者 1，-0.2±0.4；观察者 2，0.0±0.0）明显高于 40keV 混合 IR（观察者 1，-0.5±0.5；观察者 2，-1.0±0.0；P<0.05）、70keV DLIR（观察者 1，-1.8±0.4；观察者 2，-2.0±0.0；P<0.001）和 70keV 混合 IR 图像（观察者 1，-1.8±0.4；观察者 2，-2.4±0.5；P<0.001）。
与 70keV VMI 联合混合 IR 或 DLIR 相比，使用 40keV VMI 联合 DLIR 可改善 EVAR 后 EL 的描绘。
