优化高心率时支架CT成像的体模实验研究

马天; 李芳; 周艳; 许英浩; 贺毅

doi:10.15953/j.ctta.2024.021

优化高心率时支架CT成像的体模实验研究

首都医科大学附属北京友谊医院放射科, 北京100050

基金项目: 国家自然科学基金面上项目（基于时序分析神经网络解析室壁形变评估心肌缺血的智能辅助诊断方法研究（82272068））。

详细信息

作者简介:
马天: 女，首都医科大学附属北京友谊医院、首都医科大学影像医学与核医学专业硕士研究生，主要从事心胸影像研究，E-mail：snoopymt@163.com

通讯作者:
贺毅: 女，首都医科大学附属北京友谊医院教授、博士生导师，主要从事心血管影像研究，E-mail：heyi139@sina.com。

中图分类号: R 331
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出版历程
- 收稿日期: 2024-01-28
- 修回日期: 2024-03-25
- 录用日期: 2024-03-27
- 网络出版日期: 2024-05-09
- 刊出日期: 2024-09-04

A Phantom Experimental Study on Improving the Imaging Quality of Stent CT at a Fast Heart Rate

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

摘要

摘要:
目的：本研究探讨不同成像参数对高心率时体模支架成像及支架内狭窄程度判读的影响，在保证图像质量的前提下，降低辐射剂量，为今后临床工作中高心率患者的支架CT成像参数优化提供理论依据。方法：本研究通过设置不同成像参数，获得高心率时体模支架的多组CT图像；共有4支不同内径的冠状动脉支架，每枚支架内设置4种狭窄程度，分批注入2种不同浓度碘对比剂；利用佳能320 CT机分别采用100 kV和120 kV管电压扫描，均以支架重建模式进行图像重建；两位有3年以上冠脉CT诊断经验的放射科医生采用5分制评分法，对支架可视化效果、图像质量、支架内狭窄的评估，进行图像质量主观评分；采用多元回归分析，评估支架内径、支架内狭窄程度、管电压、碘对比剂浓度对图像质量主观评分的统计学影响。结果：在所有参数组合中，4种内径支架的结构均可显示，但支架腔内显示存在差异；支架内径、支架内狭窄程度、碘对比剂浓度对图像质量主观评分影响显著，随着支架内径的增加和支架内狭窄程度的减轻、碘对比剂浓度的减低，评分上升，支架内径对评分的影响最为强烈；管电压对图像质量主观评分影响不显著。结论：高心率条件下，支架内径、支架内狭窄程度和碘对比剂浓度直接影响支架CT成像的图像质量，而管电压对图像质量没有影响。本研究可为优化高心率人群的支架成像方案提供理论基础。
- 计算机体层成像 /
- 体模 /
- 支架 /
- 高心率
Abstract:
Objective: This study aimed to investigate the impact of different imaging parameters on stent imaging and stenosis assessment in a fast heart rate model. The goal was to reduce the radiation dose while ensuring image quality, and to provide a theoretical basis for optimizing computed tomography (CT) imaging parameters for stent imaging in patients with fast heart rates in future clinical practice. Methods: Different imaging parameters were set to obtain multiple sets of CT images of stents in a fast heart rate model. Four coronary artery stents with different internal diameters were used. Each stent was set to four levels of stenosis. Two different concentrations of iodine contrast agents were injected in batches. The Canon 320 CT scanner was used to perform scans at 100 kV and 120 kV tube voltages, and image reconstruction was performed using the stent reconstruction mode. Two radiologists, with more than three years of experience in coronary CT diagnosis, used a 5-point scoring method to subjectively evaluate image quality based on stent visualization, image quality, and stenosis assessment. Multiple regression analysis was conducted to assess the influence of stent diameter, stenosis level, tube voltage, and iodine contrast agent concentration on the subjective image quality scores. Results: The structures of the four stents could be visualized in all parameter combinations, but there were significant differences in the intraluminal display. The stent diameter, stenosis level, and iodine contrast agent concentration had a significant impact on the subjective image quality scores. The scores increased as the stent diameter increased and the stenosis level and iodine contrast agent concentration decreased. Moreover, the stent diameter had the strongest impact on the scores. Tube voltage did not significantly affect the subjective image quality scores. Conclusion: In fast heart rate conditions, the stent diameter, stenosis level, and iodine contrast agent concentration directly affect the image quality of stent CT imaging. Conversely, tube voltage had no impact on image quality. Our findings provided a theoretical basis for optimizing stent imaging protocols in patients with fast heart rates.
- computed tomography /
- phantom /
- stent /
- high heart rate

HTML全文

图 1 体模实验中不同内径支架的CT图像

注：模拟心率90次/min时，注入A组碘对比剂后，采用100 kV管电压扫描获得的4种不同内径支架的CT图像，各支架结构均可显示，其中4、3.5和3 mm内径的支架内碘对比剂与梯度狭窄的分界均可显示，2.75 mm内径的支架内部显示不清。

Figure 1. CT images of different internal diameter stents in the phantom experiment

下载: 全尺寸图片幻灯片

表 1 模型拟合度分析

Table 1 Model fit analysis

模型摘要	R	R²	调整后R²	标准误	更改统计
模型摘要	R	R²	调整后R²	标准误	R²	F	自由度1	自由度2	P
1	0.868	0.753	0.736	0.338	0.753	44.981	4	59	0.000

下载: 导出CSV

表 2 回归模型显著性分析

Table 2 Significance analysis of regression model

模型ANOVA	平方和	自由度	均方	统计检验
模型ANOVA	平方和	自由度	均方	F	P
回归	20.603	4	5.151	44.981	0.000^b
残差	6.756	59	0.115
总计	27.359	63

下载: 导出CSV

表 3 模型参数的显著性检验结果

Table 3 Significance test results of model parameters

模型系数	未标准化系数		标准化系数	统计检验		B的95.0％置信区间		相关性
模型系数	B	标准误	Beta	t	显著性	下限	上限	零阶	偏	部分
（常量）	2.584	0.781		3.311	0.002	1.023	4.146
支架内径	1.140	0.088	0.837	12.936	0.000	0.964	1.316	0.837	0.860	0.837
狭窄程度	-0.347	0.161	-0.140	-2.159	0.035	-0.669	-0.025	-0.140	-0.271	-0.140
管电压	-0.005	0.004	-0.072	-1.108	0.272	-0.013	0.004	-0.072	-0.143	-0.072
碘对比剂浓度	-0.004	0.001	-0.167	-2.586	0.012	-0.006	-0.001	-0.167	-0.319	-0.167

下载: 导出CSV

表 4 回归模型预测偏差性分析

Table 4 Regression model prediction bias analysis

残差统计	最小值	最大值	平均值	标准偏差	个案数
预测值	3.382	5.363	4.297	0.572	64
残差	-0.632	0.693	0.000	0.327	64
标准预测值	-1.599	1.864	0.000	1.000	64
标准残差	-1.868	2.049	0.000	0.968	64

下载: 导出CSV

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