ISSN 1004-4140
    CN 11-3017/P

    水等效直径对低管电压冠状动脉CTA效率增益及运动校正的影响

    Effects of Water-equivalent Diameter on Efficiency Gain and Motion Correction Performance in Low-tube-voltage Coronary CT Angiography

    • 摘要: 目的:探讨水等效直径(WED)对低管电压冠状动脉 CT 血管成像中运动校正剂量效率增益的影响,在此基础上比较不同代次 Freeze 运动校正的表现差异。方法:前瞻性纳入接受低管电压 CCTA 检查的受试者 104 例。基于同次扫描原始数据分别重建 Freeze 0、Freeze 1.0 和 Freeze 2.0 图像。采用标准化 ROI 测量计算剂量归一化对比噪声比(nCNR)及相关客观指标,并进行主观图像质量评分和诊断可用性评价。通过相关分析评估 WED 与基线 nCNR 及增益指标 ΔnCNR 的关系,建立线性混合效应模型检验 Freeze×WED 交互作用,并采用分段线性回归探索 WED 的参考阈值。结果:WED 与基线 nCNR 呈显著负相关,提示随着衰减负荷增加,低管电压 CCTA 的基线剂量归一化成像效率下降。WED 与 ΔnCNR 亦呈负相关,表明 Freeze 运动校正带来的剂量效率增益随 WED 增大而递减。线性混合效应模型显示 Freeze×WED 交互显著。总体上,Freeze 代际升级可改善单位剂量下的图像质量表现,nCNR 由 5.04±1.28(Freeze 0)升至 6.03±1.51(Freeze 2.0)(均 P < 0.001),主观评分与诊断可用性同步提高。分段回归及 bootstrap 分析提示,约 28.0 cm 的 WED 可能是运动校正边际收益开始受限的探索性参考阈值。结论:WED 可显著调制低管电压 CCTA 中 Freeze 运动校正的剂量效率增益,且 WED 增大时基线成像效率及运动校正边际收益均降低,可作为个体化优化的重要参考指标。

       

      Abstract: Objective: To investigate whether water-equivalent diameter (WED) modulates the dose-efficiency gain of Freeze motion correction in low-tube-voltage coronary computed tomography angiography (CCTA), and to compare the performance of different generations of Freeze algorithms. Methods: In this prospective study, 104 participants who underwent low-tube-voltage CCTA were enrolled. Images were reconstructed from the same raw scan data for Freeze 0, Freeze 1.0, and Freeze 2.0. The dose-normalized contrast-to-noise ratio (nCNR) and related objective metrics were derived from standardized region-of-interest measurements, and the subjective image quality scores and diagnostic usability were assessed. Correlation analyses were performed to evaluate the associations of WED with the baseline nCNR and gain metric ΔnCNR. A linear mixed-effects model was used to test the freeze × WED interaction, and segmented linear regression was applied to explore a practical WED threshold. Results: WED was significantly and inversely correlated with baseline nCNR, indicating a reduced baseline dose-normalized imaging efficiency with increasing attenuation burden. WED was also negatively correlated with ΔnCNR, suggesting that the dose-efficiency gain from Freeze motion correction decreased as WED increased. The mixed-effects model confirmed significant Freeze × WED interactions. Overall, generational Freeze upgrades improved image quality per unit dose, with nCNR increasing from 5.04±1.28 (Freeze 0) to 6.03±1.51 (Freeze 2.0) (all P < 0.001), accompanied by parallel improvements in subjective scores and diagnostic usability. Segmented regression and bootstrap analyses suggested that a WED of approximately 28.0 cm may represent an exploratory threshold beyond which the marginal benefit of motion correction is attenuated. Conclusion: WED significantly modulated the dose-efficiency gain of freeze-motion correction in low-tube-voltage CCTA. Higher WED values were associated with reduced baseline imaging efficiency and diminished marginal benefit from motion correction, thereby providing an important reference for individualized optimization.

       

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