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光子计数计算机断层扫描在冠状动脉成像中的技术原理、优势、挑战及应用：一篇综述

Technical principles, benefits, challenges, and applications of photon counting computed tomography in coronary imaging: a narrative review.

作者信息

Meloni Antonella, Maffei Erica, Positano Vincenzo, Clemente Alberto, De Gori Carmelo, Berti Sergio, La Grutta Ludovico, Saba Luca, Bossone Eduardo, Mantini Cesare, Cavaliere Carlo, Punzo Bruna, Celi Simona, Cademartiri Filippo

机构信息

Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.

Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.

出版信息

Cardiovasc Diagn Ther. 2024 Aug 31;14(4):698-724. doi: 10.21037/cdt-24-52. Epub 2024 Jul 31.

DOI:10.21037/cdt-24-52
PMID:39263472
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11384460/
Abstract

BACKGROUND AND OBJECTIVE

The introduction of photon-counting computed tomography (PCCT) represents the most recent groundbreaking advancement in clinical computed tomography (CT). PCCT has the potential to overcome the limitations of traditional CT and to provide new quantitative imaging information. This narrative review aims to summarize the technical principles, benefits, and challenges of PCCT and to provide a concise yet comprehensive summary of the applications of PCCT in the domain of coronary imaging.

METHODS

A review of PubMed, Scopus, and Google Scholar was performed until October 2023 by using relevant keywords. Articles in English were considered.

KEY CONTENT AND FINDINGS

The main advantages of PCCT over traditional CT are enhanced spatial resolution, improved signal and contrast characteristics, diminished electronic noise and image artifacts, lower radiation exposure, and multi-energy capability with enhanced material discrimination. These key characteristics have made room for improved assessment of plaque volume and severity of stenosis, more precise assessment of coronary artery calcifications, also preserved in the case of a reduced radiation dose, improved assessment of plaque composition, possibility to provide details regarding the biological processes occurring within the plaque, enhanced quality and accuracy of coronary stent imaging, and improved radiomic analyses.

CONCLUSIONS

PCCT can significantly impact diagnostic and clinical pathways and improve the management of patients with coronary artery diseases (CADs).

摘要

背景与目的

光子计数计算机断层扫描（PCCT）的引入代表了临床计算机断层扫描（CT）领域最新的突破性进展。PCCT有潜力克服传统CT的局限性，并提供新的定量成像信息。本叙述性综述旨在总结PCCT的技术原理、优势和挑战，并对PCCT在冠状动脉成像领域的应用提供简洁而全面的总结。

方法

截至2023年10月，使用相关关键词对PubMed、Scopus和谷歌学术进行了检索。纳入英文文章。

关键内容与发现

与传统CT相比，PCCT的主要优势包括增强的空间分辨率、改善的信号和对比特性、减少的电子噪声和图像伪影、更低的辐射剂量以及具有增强物质辨别能力的多能量功能。这些关键特性为改善斑块体积和狭窄严重程度的评估、更精确地评估冠状动脉钙化（即使在辐射剂量降低的情况下也能保留）、改善斑块成分评估、提供斑块内发生的生物学过程细节的可能性、提高冠状动脉支架成像的质量和准确性以及改进放射组学分析创造了空间。

结论

PCCT可显著影响诊断和临床路径，并改善冠状动脉疾病（CAD）患者的管理。

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