Ayx Isabelle, Schwenke Kay, Rotkopf Lukas, Kayed Hany, Buettner Sylvia, Schoenberg Stefan O, Thater Greta
Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Department of Vascular Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Eur J Radiol. 2025 May;186:112050. doi: 10.1016/j.ejrad.2025.112050. Epub 2025 Mar 13.
Photon-Counting Computed Tomography (PCCT) offers significant advancements in aortic imaging, especially for vascular applications. Its Ultra-High-Resolution (UHR) mode enhances the visualization of small vascular structures, aiding surgical planning while reducing radiation exposure. This study assesses whether UHR abdominal aortic angiography with PCCT improves resolution and noise ratio compared to Energy-Integrating Computed Tomography (EICT) without increasing radiation dose.
In this retrospective study, 25 patients underwent Ultra-High-Resolution abdominal CT angiography (PCCT) and were compared to 25 patients, who underwent abdominal CT angiography on an EICT scanner. Ethical approval was obtained. Image quality was assessed using Signal-to-Noise Ratio (SNR), Contrast-to-Noise Ratio (CNR), and a five-point Likert scale. Radiation doses were compared using CTDIvol, DLP, and effective dose, with statistical significance set at p < 0.05.
The PCCT group showed significantly lower radiation exposure (CTDIvol: 4.7 mGy vs. 7.3 mGy, p = 0.0081; effective dose: 3.4 mSv vs. 6.5 mSv, p = 0.0057). Although PCCT had higher SNR and CNR, differences were statistically significant only for renal arteries (p = 0.0432). Subjective image quality was significantly better for PCCT (p < 0.0001).
This study outlines the feasibility of UHR mode using PCCT in improving the contrast-to-noise and signal-to-noise ratio in patients undergoing abdominal CT angiography in the arterial phase as well as improved image quality of visceral arteries compared to EICT, accompanied by a significant reduction in radiation dose. This supports its recommending PCCT angiography for use in reducing patient exposure while improving image quality.
光子计数计算机断层扫描（PCCT）在主动脉成像方面取得了重大进展，特别是在血管应用中。其超高分辨率（UHR）模式增强了小血管结构的可视化，有助于手术规划，同时减少辐射暴露。本研究评估与能量积分计算机断层扫描（EICT）相比，PCCT的UHR腹主动脉血管造影在不增加辐射剂量的情况下是否能提高分辨率和噪声比。
在这项回顾性研究中，25例患者接受了超高分辨率腹部CT血管造影（PCCT），并与25例在EICT扫描仪上接受腹部CT血管造影的患者进行比较。获得了伦理批准。使用信噪比（SNR）、对比噪声比（CNR）和五点李克特量表评估图像质量。使用容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）和有效剂量比较辐射剂量，统计学显著性设定为p < 0.05。
PCCT组的辐射暴露显著更低（CTDIvol：4.7 mGy对7.3 mGy，p = 0.0081；有效剂量：3.4 mSv对6.5 mSv，p = 0.0057）。虽然PCCT的SNR和CNR更高，但仅肾动脉的差异具有统计学显著性（p = 0.0432）。PCCT的主观图像质量显著更好（p < 0.0001）。
本研究概述了在动脉期接受腹部CT血管造影的患者中，使用PCCT的UHR模式提高对比噪声比和信噪比以及与EICT相比改善内脏动脉图像质量的可行性，同时辐射剂量显著降低。这支持推荐使用PCCT血管造影以减少患者暴露并提高图像质量。
