基于单光子计数 CT 的超高分辨率及虚拟非钙算法在狭窄病变评估中的准确性：一项动态体模研究结果。
Accuracy of ultra-high resolution and virtual non-calcium reconstruction algorithm for stenosis evaluation with photon-counting CT: results from a dynamic phantom study.
机构信息
Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
出版信息
Eur Radiol Exp. 2024 Aug 29;8(1):102. doi: 10.1186/s41747-024-00482-w.
BACKGROUND
We compared ultra-high resolution (UHR), standard resolution (SR), and virtual non-calcium (VNCa) reconstruction for coronary artery stenosis evaluation using photon-counting computed tomography (PC-CT).
METHODS
One vessel phantom (4-mm diameter) containing solid calcified lesions with 25% and 50% stenoses inside a thorax phantom with motion simulation underwent PC-CT using UHR (0.2-mm slice thickness) and SR (0.6-mm slice thickness) at heart rates of 60 beats per minute (bpm), 80 bpm, and 100 bpm. A paired t-test or Wilcoxon test with Bonferroni correction was used.
RESULTS
For 50% stenosis, differences in percent mean diameter stenosis between UHR and SR at 60 bpm (51.0 vs 60.3), 80 bpm (51.7 vs 59.6), and 100 bpm (53.7 vs 59.0) (p ≤ 0.011), as well as between VNCa and SR at 60 bpm (50.6 vs 60.3), 80 bpm (51.5 vs 59.6), and 100 bpm (53.7 vs 59.0) were significant (p ≤ 0.011), while differences between UHR and VNCa at all heart rates (p ≥ 0.327) were not significant. For 25% stenosis, differences between UHR and SR at 60 bpm (28.0 vs 33.7), 80 bpm (28.4 vs 34.3), and VNCa vs SR at 60 bpm (29.1 vs 33.7) were significant (p ≤ 0.015), while differences for UHR vs SR at 100 bpm (29.9 vs 34.0), as well as for VNCa vs SR at 80 bpm (30.7 vs 34.3) and 100 bpm (33.1 vs 34.0) were not significant (p ≥ 0.028).
CONCLUSION
Stenosis quantification accuracy with PC-CT improved using either UHR acquisition or VNCa reconstruction.
RELEVANCE STATEMENT
PC-CT offers to scan with UHR mode and the reconstruction of VNCa images both of them could provide improved coronary stenosis quantification at increased heart rates, allowing a more accurate stenosis grading at low and high heart rates compared to SR.
KEY POINTS
Evaluation of coronary stenosis with conventional CT is challenging at high heart rates. PC-CT allows for scanning with ECG-gated UHR and SR modes. UHR and VNCa images were compared in a dynamic phantom. UHR improves stenosis quantification up to 100 bpm. VNCa reconstruction improves stenosis evaluation up to 80 bpm.
背景
我们比较了超高分辩率（UHR）、标准分辩率（SR）和虚拟非钙（VNCa）重建在使用光子计数 CT（PC-CT）评估冠状动脉狭窄中的应用。
方法
一个血管体模（4mm 直径），包含一个胸部体模中的实性钙化病变，有 25%和 50%狭窄，并带有运动模拟，在心率为 60 次/分钟（bpm）、80 bpm 和 100 bpm 时使用 UHR（0.2mm 层厚）和 SR（0.6mm 层厚）进行 PC-CT。采用配对 t 检验或 Wilcoxon 检验，Bonferroni 校正。
结果
对于 50%狭窄，UHR 与 SR 在 60 bpm（51.0 比 60.3）、80 bpm（51.7 比 59.6）和 100 bpm（53.7 比 59.0）（p≤0.011）以及 VNCa 与 SR 在 60 bpm（50.6 比 60.3）、80 bpm（51.5 比 59.6）和 100 bpm（53.7 比 59.0）（p≤0.011）之间的平均直径狭窄百分比差异有统计学意义，而在所有心率下 UHR 与 VNCa 之间的差异（p≥0.327）没有统计学意义。对于 25%狭窄，UHR 与 SR 在 60 bpm（28.0 比 33.7）、80 bpm（28.4 比 34.3）和 VNCa 与 SR 在 60 bpm（29.1 比 33.7）之间的差异有统计学意义（p≤0.015），而 UHR 与 SR 在 100 bpm（29.9 比 34.0）以及 VNCa 与 SR 在 80 bpm（30.7 比 34.3）和 100 bpm（33.1 比 34.0）之间的差异没有统计学意义（p≥0.028）。
结论
PC-CT 采用 UHR 采集或 VNCa 重建，均可提高冠状动脉狭窄定量准确性。
相关性陈述
PC-CT 可提供 UHR 模式扫描和 VNCa 图像重建，两者均可在心率增加时提高冠状动脉狭窄定量的准确性，与 SR 相比，在低和高心率时都能更准确地进行狭窄分级。
关键点
常规 CT 评估冠状动脉狭窄在高心率时具有挑战性。PC-CT 允许使用 ECG 门控 UHR 和 SR 模式进行扫描。在动态体模中比较了 UHR 和 VNCa 图像。UHR 将狭窄定量提高到 100 bpm。VNCa 重建可提高 80 bpm 时的狭窄评估。
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