Lu Zhihua, Wu Suying, Wu Feijian, Jin Qingdong, Huang Qingjing, Zhang Baoteng
The First Hospital of Putian City, Department of Radiology, Putian, China.
The First Hospital of Putian City, Department of Neurosurgery, Putian, China.
Diagn Interv Radiol. 2025 Apr 28;31(3):264-273. doi: 10.4274/dir.2024.242975. Epub 2024 Dec 16.
This study aimed to research the optimal energy range of dual-energy computed tomography angiography (DECTA)-based virtual monoenergetic imaging (VMI) for evaluations after cerebral aneurysm clipping.
Sixty patients who underwent DECTA after cerebral aneurysm clipping were analyzed retrospectively. Conventional computed tomography angiography (CTA) was compared with VMIs at 60, 70, 80, 90, and 100 keV. The mean attenuation and standard deviation values within the regions of interest placed in the brain parenchyma and arteries with the worst artifact were measured, respectively. The ΔCT and artifact index (AI) values were calculated to assess the artifact severity. The contrast-to-noise ratio (CNR) was calculated to assess vascular contrast. Two radiologists assessed brain parenchyma and cerebrovascular scores qualitatively using a five-point Likert scale.
Quantitative analysis showed that the artifacts of VMIs were significantly reduced compared with conventional CTA ( ≤ 0.014), except for the ΔCT and AI of 60 keV and the ΔCT of 70 keV. However, there was no significant difference in the vascular contrast on VMIs compared with conventional CTA, except for the CNR of 60 keV ( = 0.008). In qualitative analysis, the proportions of brain parenchyma scores and cerebrovascular scores ≥4 on the VMIs of 70 and 80 keV were higher than those of conventional CTA and other VMIs.
For the patients who underwent DECTA after cerebral aneurysm clipping, the 70-80 keV VMIs are expected to be the optimal energy range for balancing clip artifacts and visibility of adjacent vessels.
Studying the optimal energy range of DECTA-based VMI for post-operative assessment of aneurysm clipping can reduce metal artifacts in images and increase vascular contrast. This facilitates the follow-up of patients after aneurysm clipping, offers timely and accurate detection of postoperative complications, provides assistance to clinicians in diagnosis and treatment, and improves patient prognosis.
本研究旨在探讨基于双能计算机断层血管造影（DECTA）的虚拟单能量成像（VMI）在脑动脉瘤夹闭术后评估中的最佳能量范围。
回顾性分析60例脑动脉瘤夹闭术后接受DECTA检查的患者。将传统计算机断层血管造影（CTA）与60、70、80、90和100 keV的VMI进行比较。分别测量置于脑实质和伪影最严重动脉区域内的感兴趣区的平均衰减值和标准差。计算ΔCT和伪影指数（AI）值以评估伪影严重程度。计算对比噪声比（CNR）以评估血管对比度。两名放射科医生使用五点李克特量表对脑实质和脑血管评分进行定性评估。
定量分析显示，除60 keV的ΔCT和AI以及70 keV的ΔCT外，VMI的伪影与传统CTA相比显著减少（≤0.014）。然而，与传统CTA相比，VMI的血管对比度除60 keV的CNR外（=0.008）无显著差异。定性分析中，70和80 keV的VMI上脑实质评分和脑血管评分≥4的比例高于传统CTA和其他VMI。
对于脑动脉瘤夹闭术后接受DECTA检查的患者，70 - 80 keV的VMI有望成为平衡夹子伪影和相邻血管可视性的最佳能量范围。
研究基于DECTA的VMI在动脉瘤夹闭术后评估中的最佳能量范围可减少图像中的金属伪影并增加血管对比度。这有助于动脉瘤夹闭术后患者的随访，及时准确地检测术后并发症，为临床医生的诊断和治疗提供帮助，并改善患者预后。
