CAJ | 학술논문

目的：评价640层 CT 冠状动脉造影（CTCA）三维自适应迭代剂量降低（AIDR3D）重建算法的图像质量及辐射剂量。方法连续性84例患者接受640层 CT 自动曝光扫描冠状动脉造影检查，在图像后处理工作站分别采用 AIDR3D、滤波反投影（FBP）算法对扫描的原始图像数据进行重建。2位不知道临床信息及重建算法并且富有经验的影像科医生独立测量、计算2种重建算法 CTCA 的图像噪声、信噪比和对比噪声比，4等级法定性评价 CTCA 的图像质量。根据 CT 机扫描输出的剂量长度乘积计算辐射剂量。统计分析比较2种重建算法 CTCA 的定量及定性图像质量。结果AIDR3D 重建算法 CTCA 的图像噪声为（27．20±4．40）HU，较 FBP（60．00±12．40）HU 减少了46．10％，信噪比21．10±5．10较 FBP 11．40±2．80提高了84．70％，对比噪声比24．70±5．10较 FBP 13．50±3．20提高了82．20％，二者比较均差异有统计学意义（P ＜0．05）。AIDR3D 重建算法冠状动脉近部、中部、远部的图像质量定性评价分数分别为（3．90±0．30）、（3．70±0．50）、（3．60±0．60）分，均高于 FBP[分别为（2．60±0．60）、（2．30±0．60）、（2．10±0．70）分]，二者比较均差异有统计学意义（P ＜0．05）。AIDR3D、FBP 重建算法可以用于诊断的冠状动脉总段数分别为1216段（96．50％）、504段（40．00％），二者比较差异有统计学意义（P ＜0．05）。平均有效辐射剂量为（2．10±1．00）mSv。结论640层 CTCA AIDR3D 重建算法不仅较常规的 FBP 重建算法的图像噪声显著减少，定量及定性图像质量均明显提高，而且有效辐射剂量低。
목적：평개640층 CT 관상동맥조영（CTCA）삼유자괄응질대제량강저（AIDR3D）중건산법적도상질량급복사제량。방법련속성84례환자접수640층 CT 자동폭광소묘관상동맥조영검사，재도상후처리공작참분별채용 AIDR3D、려파반투영（FBP）산법대소묘적원시도상수거진행중건。2위불지도림상신식급중건산법병차부유경험적영상과의생독립측량、계산2충중건산법 CTCA 적도상조성、신조비화대비조성비，4등급법정성평개 CTCA 적도상질량。근거 CT 궤소묘수출적제량장도승적계산복사제량。통계분석비교2충중건산법 CTCA 적정량급정성도상질량。결과AIDR3D 중건산법 CTCA 적도상조성위（27．20±4．40）HU，교 FBP（60．00±12．40）HU 감소료46．10％，신조비21．10±5．10교 FBP 11．40±2．80제고료84．70％，대비조성비24．70±5．10교 FBP 13．50±3．20제고료82．20％，이자비교균차이유통계학의의（P ＜0．05）。AIDR3D 중건산법관상동맥근부、중부、원부적도상질량정성평개분수분별위（3．90±0．30）、（3．70±0．50）、（3．60±0．60）분，균고우 FBP[분별위（2．60±0．60）、（2．30±0．60）、（2．10±0．70）분]，이자비교균차이유통계학의의（P ＜0．05）。AIDR3D、FBP 중건산법가이용우진단적관상동맥총단수분별위1216단（96．50％）、504단（40．00％），이자비교차이유통계학의의（P ＜0．05）。평균유효복사제량위（2．10±1．00）mSv。결론640층 CTCA AIDR3D 중건산법불부교상규적 FBP 중건산법적도상조성현저감소，정량급정성도상질량균명현제고，이차유효복사제량저。
Objective To investigate the image quality and radiation dose of 640-slice CT coronary arteriography(CTCA) with adaptive iterative dose reduction three-dimensional (AIDR3D)reconstrucction algoritym.Methods 640-slice CTCA with auto-matic exposure was performed on 84 consecutive patients.The original image data were reconstructed with AIDR3D and the filtered back-projection (FBP)algorithms at the image postprocessing workstation.Two experienced radiologists without knowing clinical information and reconstruction algorithms independently measured and calculated the image noise,signal-to-noise ratio and contrast-to-noise ratio with AIDR3D and FBP reconstruction algorithms.The qualitative image quality was assessed by using the 4-point scale.The radiation dose was calculated based on dose-length product exported on CT scanner.The quantitative and qualitative im-age quality with two kinds of reconstruction algorithm was analyzed statistically.Results The CTCA image noise was (27.20± 4.40)HU with AIDR3D and (60.00±12.40)HU with FBP,which with AIDR3D was decreased by 46.10% than that with FBP;the signal-to-noise ratio was 21.10 ± 5.10 with AIDR3D and 11.40 ± 2.80 with FBP,which with AIDR3D was increased by 84.70% than that with FBP;the contrast-to-noise ratio was 24.70±5.10 with AIDR3D and 13.50±3.20 with FBP,which with AIDR3D was raised by 82.20% than that with FBP,the differences in 3 indexes between the two kinds of reconstruction algorithm were statistically significant(P < 0.05 ).The CTCA qualitative image quality scores of proximal,middle and distal parts with AIDR3D were (3.90±0.30),(3.70±0.50)and (3.60±0.60)respectively,which all were higher than (2.60±0.60),(2.30± 0.60)and (2.10±0.70)with FBP respectively,the differences in 3 items between 2 kinds of algorithm had statistical significance (P <0.05).The total segments which could be used to diagnose the CTCA images with AIDR3D and FBP algorithms were 1 216 segments (96.50%)and 504 segments (40.00%),respectively,the difference had statistical significance(P <0.05).The mean ef-fective radiation dose was (2.10±1.00)mSv.Conclusion 640-slice CTCA with AIDR3D reconstruction algorithm not only signifi-cantly reduces the image noise than the conventional FBP algorithm,improves the quantitative and qualitative image quality,but also decreases the effective radiation dose.