基于AI的新迭代重建算法与低管电压在降低肥胖患者冠状动脉CTA辐射剂量中的应用

冯梦雅; 李冰; 吴敏; 华婷; 汤光宇

doi:10.15953/j.ctta.2022.148

基于AI的新迭代重建算法与低管电压在降低肥胖患者冠状动脉CTA辐射剂量中的应用

冯梦雅^1,,
李冰²,
吴敏²,
华婷²,
汤光宇^2, ,

1.
武汉科技大学附属武昌医院放射科，武汉430063
2.
同济大学附属第十人民医院放射科, 上海200072

详细信息

作者简介:
冯梦雅: 女，本科，武汉科技大学附属武昌医院放射科技师，主要从事医学影像技术工作，E-mail：94080245@qq.com

通讯作者:
汤光宇: 男，同济大学医学院教授、博士生导师，同济大学附属第十人民医院放射科主任医师，主要从事骨肌影像诊断，E-mail：tgy17@tongji.edu.cn

中图分类号: O 242；R 814
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出版历程
- 收稿日期: 2022-07-29
- 修回日期: 2022-11-16
- 录用日期: 2022-11-22
- 网络出版日期: 2023-01-13
- 刊出日期: 2023-10-31

Application of New Iterative Reconstruction Algorithm Based on Artificial Intelligence and Low Tube Voltage in Reducing the Radiation Dose of Coronary CTA in Obese Patients

1.
Department of Radiology, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430063, China
2.
Department of Radiology, The Affiliated Tenth People’s Hospital of Shanghai, Tongji University, Shanghai 200072, China

摘要

摘要:
目的：探讨采用基于AI的新迭代重建算法与低管电压在降低肥胖患者冠状动脉CTA辐射剂量的可行性。方法：选取行冠状动脉CTA检查的肥胖患者40例，随机分为两组。常规剂量组（A组）和低管电压剂量组（B组）各20例。常规剂量组采用管电压120 kV，管电流200 mAS扫描，低剂量组采用管电压80 kV，管电流200 mAS。采集数据传输到后处理工作站后，分别采用常规迭代重建算法和基于AI的新迭代重建算法的图像重建，对比分析两组的主动脉平均CT值、主动脉及左冠状动脉的信噪比、对比噪声比和右冠状动脉的噪声、信噪比。结果：B组主动脉的平均CT值、主动脉及左冠状动脉的信噪比、对比噪声比和右冠状动脉的噪声、信噪比、对比噪声比与A组无明显统计学差异；两组冠状动脉主观图像质量评分无明显差异；但B组的辐射剂量较A组降低68.2％。结论：新迭代重建算法能够显著性提高重建的图像质量，在新迭代重建算法的加持下，用80 kVp的管电压可以明显降低辐射剂量，同时获得与常规剂量图像质量相当的冠状动脉CTA图像。
- 迭代重建算法 /
- 辐射剂量 /
- 冠状动脉血管成像
Abstract:
Objective: To explore the feasibility of using a new artificial intelligence (AI)-based iterative reconstruction algorithm with low tube voltage to reduce the radiation dose of coronary computed tomography angiography (CTA) in obese patients. Methods: A total of 40 patients were randomly divided into routine-dose (group A n=20) and low-dose groups (group B n=20). In group A, a tube voltage of 120 kV and a tube current of 200 mAs, whereas in group B, a tube voltage of 80 kV and a tube current of 200 mAs were used. The collected data was transferred to the post-processing workstation. The image reconstructions of the conventional and new iterative reconstruction algorithms based on AI were used. Comparative analysis of average CT value of the aorta, signal to noise ratio (SNR) and contrast to noise ratio (CNR) of the aorta and left coronary, SNR and CNR of right coronary in the two groups. Results: The average CT value of the aorta in group B, the SNR and CNR of the aorta and the left coronary artery, the SNR and CNR of the right coronary artery was not significantly different from those of group A. There was no difference in the subjective image quality between the two groups. However, the radiation dose in patients of group B was reduced by 68.2% compared with that of group A. Conclusion: The new iterative reconstruction algorithm can significantly improve the image quality of the reconstruction. The radiation dose can be significantly reduced with a tube voltage of 80 kVp, and the coronary CTA image equivalent to the image quality of the conventional dose can be obtained.
- iterative algorithm /
- radiation dose /
- coronary angiography

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图 1 低剂量组和常规剂量组冠状动脉扫描图像质量的对比

（a）～（c）低管电压剂量组患者，男，49岁，体重103 kg；采用80 kV，200 mAs扫描，触发阈值为90 HU；ED为1.52 mSv。（a）示主动脉强化CT值为407 HU；（b）为左前降支CPR图像，管壁显示较清晰，组织对比度好，图像评分为4分。（c）为VR图像，能清晰显示冠状动脉三级分支，图像评分为4分。（d）～（f）常规组患者，男，52岁，体重115 kg；采用120 kV，200 mAs扫描，触发阈值为120 HU；ED为2.57 mSv。（d）示主动脉强化CT值为314 HU。（e）为左前降支CPR图像，管壁显示较清晰，组织对比度较好，图像评分为4。（f）分为VR图像，能较清晰显示冠状动脉三级分支，图像评分为4分。

Figure 1. Comparison of image quality in the low-dose and routine-dose groups

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表 1 常规剂量组（A组）和低剂量组（B组）一般资料的比较

Table 1 Comparison of general information in the routine-dose (group A) and low-dose groups (group B)

项目	组别		统计校验
项目	A组（20例）	B组（20例）	t	p
年龄	45.2±10.4	48.1±11.2	0.62	>0.05
体重	120.3±1.7	127.2±1.8	1.05	>0.05
心率	70.5±5.2	73.2±4.5	1.97	>0.05

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表 2 常规剂量组（A组）和低剂量组（B组）图像质量比较

Table 2 Comparison of image quality in the routine-dose (group A) and low-dose groups (group B)

测量参数	图像质量		统计检验
测量参数	A组（20例）	B组（20例）	t	P
主动脉CT值	396.7±63.4	375.5±65.5	1.55	>0.05
主动脉/左冠状动脉SNR	13.3±1.6	12.9±1.9	1.85	>0.05
主动脉/左冠状动脉CNR	12.6±2.0	12.2±1.6	1.45	>0.05
主动脉/右冠状动脉SNR	17.6±2.5	16.7±3.1	1.48	>0.05
主动脉/右冠状动脉CNR	22.8±2.5	22.1±3.5	1.78	>0.05

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表 3 常规剂量组（A组）和低剂量组（B组）图像质量评分比较

Table 3 Comparison of image score in the routine-dose (group A) and low-dose groups (group B)

评分	图像质量评分（可评估节段数（％））
评分	A组	B组
4分	228（85.2）	223（83.8）
3分	42（13.2）	39（11.6）
2分	22（4.2）	20（3.9）
1分	5（1.3）	4（1.0）
合格率	297（98.2）	286（96.8）

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表 4 常规剂量组（A组）和低剂量组（B组）辐射剂量比较

Table 4 Comparison of radiation dose in the routine-dose (group A) and low-dose groups (group B)

参数	辐射剂量		统计检验
参数	A组	B组	t	P
ED/mSv	2.87±0.53	1.02±0.64	7.32	<0.001

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参考文献(12)

[1]	ANDREINI D, MUSHTAQ S, CONTE E, et al. Coronary CT angiography with 80 kV tube voltage and low iodine concentration contrast agent in patients with low body weight[J]. Journal Cardiovasc Computer 2016, 10(4): 322-326.
[2]	FORTE G C, ANDRADE R G F, FIORENTINI L F, et al. Additional ultra-low-dose protocols in coronary computed tomography angiography scans to early detection of lung cancer[J]. Europe Heart Journal, 2021, 42(S1). DOI: 10.1093/eurheartj/ehab724.0193.
[3]	曹剑, 易妍, 王怡宁, 等. 70 kV超低管电压低对比剂用量冠状动脉CTA研究[J]. 放射学实践, 2014,29(6): 589−592. CAO J, YI Y, WANG Y N, et al. Preliminary study on ultra low tube voltage (70 kV) sequential scan with low-volume contrast media protocol for dual-source CT coronary angiography[J]. Radiologic Practice, 2014, 29(6): 589−592. (in Chinese).
[4]	张惠英, 陈伟彬, 马春梅, 等. 初步探讨不同扫描触发阈值技术在CT冠状动脉成像中的应用价值[J]. 临床放射学杂志, 2014,33(3): 445−449. doi: 10.13437/j.cnki.jcr.2014.03.035 ZHANG H Y, CHEN W B, MA C M, et al. The value of different scanning trigger threshold technique in CT imaging of coronary artery[J]. Journal of Clinical Radiology, 2014, 33(3): 445−449. (in Chinese). doi: 10.13437/j.cnki.jcr.2014.03.035
[5]	NAKAURA T, KIDOH M, SAKAINO N, et al. Low contrast-and low radiation does protocol for cardiac CT of thin adults at 256-row CT: Usefulness of low tube voltage scans and the hybrid iterative reconstruction algorithm[J]. International Journal Cardiovasc Imaging, 2013, 29(4): 913−923. doi: 10.1007/s10554-012-0153-y
[6]	LEMBCKE A, SCHWENKE C, HEIN P A, et al. High-pitch dual-souece CT coronary angiography with low volumes of contrast medium[J]. Europe Radiology, 2014, 24(1): 120−127. doi: 10.1007/s00330-013-2988-6
[7]	NAIDICH D P, MARSHALL C H, CRIBBIN C, et al. Low-dose CT of the lungs: Preliminary observations[J]. Radiology, 1990, 175: 729−731. doi: 10.1148/radiology.175.3.2343122
[8]	CRIMM H, FERGESTROM N M, DYE C, et al. low tube potential, coronary calcium assessment prior to coronary CT angiography: A prospective, randomized clinical trial[J]. Journal Cardiovasc Computer Tomography, 2021, 15(3): 240−245. doi: 10.1016/j.jcct.2020.08.011
[9]	SCHICCHI N, FOGANTE M, PALUMBO P, et al. The sub-millisievert era in CTCA: The technical basis of the new radiation dose approach[J]. Radiology Medicine, 2020, 125(11): 1024−1039. doi: 10.1007/s11547-020-01280-1
[10]	STOCKER T J, LEIPSIC J, HADAMITZKY M, et al. Application of low tube potentials in CCTA: Results from the protection VI study[J]. JACC Cardiovasc Imaging, 2020, 13(2 Pt 1): 425-434.
[11]	SCHUHBAECK A, ACHENBACH S, LAYRITZ C, et al. Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction[J]. Europe Radiology, 2013, 23(3): 597−606. doi: 10.1007/s00330-012-2656-2
[12]	CHA M J, KIM S M, AHN T R, et al. Comparing feasibility of low-tube-voltage protocol with low-iodine-concentration contrast and high-tube-voltage protocol with high-iodine-concentration contrast in coronary computed tomography angiography[J]. PLoS One, 2020, 15(7): e0236108. doi: 10.1371/journal.pone.0236108