ISSN 1004-4140
CN 11-3017/P
| Citation: |
WANG Y S, YANG L Q, YANG Y F, et al. The Effect of Different Trigger Thresholds on the Quality of Pulmonary Artery CT Angiography Images[J]. CT Theory and Applications, 2024, 33(2): 175-181. DOI: 10.15953/j.ctta.2023.121. (in Chinese).
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Objective: To study the effect of different triggering thresholds on the quality of pulmonary artery CT angiography (CTA) images. Materials and Methods: A prospective study included 112 patients with suspected pulmonary embolism admitted to Tinglin Hospital in the Jinshan District of Shanghai between December 2021 to April 2023. Among them, there were 49 males and 63 females aged between 37 and 93 years, with an average age of 64.28 years. Patients were randomly assigned to three groups based on trigger thresholds. Group A included 38 cases with a trigger threshold of 120 HU, Group B included 37 cases with a trigger threshold of 200 HU, and Group C included 37 cases with a trigger threshold of 250 HU. There were no statistically significant differences in gender, age, height, or weight among the three groups. One-way ANOVA was used to compare the CT values and subjective image quality scores of the superior vena cava, main pulmonary artery, left and right pulmonary arteries, and right pulmonary vein among the three groups. Result: There were no statistical differences in the CT values of the main pulmonary artery and left and right pulmonary arteries among the three groups, but there were statistical differences in the CT values of the superior vena cava and right pulmonary vein. There was a statistical difference in the subjective score of image quality among the three groups; the subjective evaluation of the obtained image quality between the two physicians was highly consistent (κ=0.78). Conclusion: When the triggering threshold of pulmonary artery CTA is 200 HU, it can not only ensure the concentration of pulmonary artery trunk CT value meets the clinical diagnosis, but also ensures that the contrast agent is fully injected into the 5~6 grade branches, leading to less retention of superior vena cava, weak pulmonary vein development, and the highest image quality of pulmonary artery CTA.
| [1] |
KONSTANTINIDES S V, MEYER G, BECATTINI C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)[J]. European Heart Journal, 2020, 41(4): 543−603. DOI: 10.1093/eurheartj/ehz405.
|
| [2] |
罗立峰, 田丰, 王俊鹏, 等. 应用低剂量对比剂肺动脉CTA成像检查肺动脉栓塞的可行性研究[J]. 中国CT和MRI杂志, 2022, 20(1): 79−81. DOI: 10.3969/j.issn.1672-5131.2022.01.025.
LUO L F, TIAN F, WANG J P, et al. Feasibility study of pulmonary artery CTA imaging with low-dose contrast agent for pulmonary embolismg[J]. Chinese Journal of CT and MRI, 2022, 20(1): 79−81. DOI: 10.3969/j.issn.1672-5131.2022.01.025. (in Chinese).
|
| [3] |
PALM V, RENGIER F, RAJIAH P, et al. Acute pulmonary embolism: Imaging techniques, findings, endovascular treatment and differential diagnoses[J]. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 2020, 192(1): 38−49. DOI: 10.1055/a-0900-4200.
|
| [4] |
奚佳汇. 肺动脉CT团注追踪技术优化扫描方案[J]. 现代医用影像学, 2020, 29(9): 1611−1614. DOI: 10.3969/j.issn.1006-7035.2020.09.010.
XI J H. Pulmonary artery CTA bolus tracking technology optimizes scanning plan[J]. Modern Medical Imaging, 2020, 29(9): 1611−1614. DOI: 10.3969/j.issn.1006-7035.2020.09.010. (in Chinese).
|
| [5] |
曾玉平, 陈观尚, 龙世亮, 等. 64层螺旋CT在肺动脉CT血管成像中自动跟踪触发扫描阈值的选择分析[J]. 中国临床新医学, 2017, 10(2): 148−152. DOI: 10.3969/j.issn.1674-3806.2017.02.16.
ZENG Y P, CHEN G S, LONG S L, et al. The option of automatic tracking triggers scanning threshold value of 64-slice spiral CT in pulmonary angiography[J]. Chinese Journal of New Clinical Medicine, 2017, 10(2): 148−152. DOI: 10.3969/j.issn.1674-3806.2017.02.16. (in Chinese).
|
| [6] |
刘曦, 孔令文, 刘翠芳, 等. 基于CT肺动脉造影的肺动脉达峰时间影响因素分析和预测模型构建[J]. 中国医学影像学杂志, 2022, 30(11): 1178−1182. DOI: 10.3969/j.issn.1005-5185.2022.11.019.
LIU X, KONG L W, LIU C F, et al. Analysis of influencing factors and constructing prediction model of time to peak in pulmonary artery based on computed tomography pulmonary angiography[J]. Chinese Journal of Medical Imaging, 2022, 30(11): 1178−1182. DOI: 10.3969/j.issn.1005-5185.2022.11.019. (in Chinese).
|
| [7] |
王永胜, 王晨思, 陆浩宇, 等. 个性化造影剂注射方案在提升肺动脉CTA生物应用安全性的价值研究[J]. CT理论与应用研究, 2021, 30(6): 777−783. DOI: 10.15953/j.1004-4140.2021.30.06.14.
WANG Y S, WANG C S, LU H Y, et al. Study on the value of individualized contrast agent injection scheme in improving the biosafety of pulmonary artery CTA[J]. CT Theory and Applications, 2021, 30(6): 777−783. DOI: 10.15953/j.1004-4140.2021.30.06.14. (in Chinese).
|
| [8] |
鸣鹏. 医学影像技术学CT检查技术卷[M]. 北京: 人民卫生出版社, 2012: 221.
|
| [9] |
KAPTEIN F, KROFT L, HAMMERSCHLAG G, et al. Pulmonary infarction in acute pulmonary embolism[J]. Thrombosis Research, 2021, 202(5): 162−169.
|
| [10] |
王永胜, 张鹏宇, 李方中, 等. 不同管电压对头颈部CTA图像质量影响的研究[J]. CT理论与应用研究, 2022, 31(5): 631−638. DOI: 10.15953/j.ctta.2022.026.
WANG Y S, ZHANG P Y, LI F Z, et al. Study on the influence of head and neck CTA image quality under different tube voltages[J]. CT Theory and Applications, 2022, 31(5): 631−638. DOI: 10.15953/j.ctta.2022.026. (in Chinese).
|
| [11] |
中华医学会放射学分会质量管理与安全管理学组. CT辐射剂量诊断参考水平专家共识[J]. 中华放射学杂志, 2017, 51(11): 817−822. DOI: 10.3760/cma.j.issn.1005-1201.2017.11.001.
Quality Management and Safety Management Group, Chinese Society of Radiology, Chinese Medical Association. Expert consensus on reference level of CT radiation dose diagnosis[J]. Chinese Journal of Radiology, 2017, 51(11): 817−822. DOI: 10.3760/cma.j.issn.1005-1201.2017.11.001. (in Chinese).
|
| [12] |
薛波, 方玉, 尹航, 等. 基于时间-密度曲线的改进的个性化肺动脉CTA扫描方案研究[J]. 中国医疗设备, 2020, 35(2): 86−89. DOI: 10.3969/j.issn.1674-1633.2020.02.021.
XUE B, FANG Y, YIN H, et al. Study on improved individualized pulmonary artery CTA scanning scheme based on time-density curve[J]. China Medical Devices, 2020, 35(2): 86−89. DOI: 10.3969/j.issn.1674-1633.2020.02.021. (in Chinese).
|
| [13] |
JAMALI L, ALIKHANI B, GETZIN T, et al. Arterial attenuation in individualized computed tomography pulmonary angiography injection protocol adjusted based on the patient's body mass index[J]. Journal of Research in Medical Sciences, 2020, 25: 94. DOI: https://doi.org/10.1055/a-0900-4200.
|
| [14] |
顾正山, 马燕, 普晓江, 等. 对比剂注射速率的不同对肺动脉CTA检查中上腔静脉伪影的影响[J]. 当代医药论丛, 2022, 20(5): 89−92. DOI: 10.3969/j.issn.2095-7629.2022.05.028.
GU Z S, MA Y, PU X J, et al. Different rate of contrast medium injection on pulmonary artery CTA check upper vena cava artifacts[J]. Contemporary Medical Symposium, 2022, 20(5): 89−92. DOI: 10.3969/j.issn.2095-7629.2022.05.028. (in Chinese).
|
| [15] |
顾庆春, 薛春华, 范晔辉, 等. 64层螺旋CT肺动脉成像触发阈值的合理选择[J]. 医学影像学杂志, 2015, 25(8): 1370−1376.
GU Q C, XUE C H, FAN Y H, et al. Comparison of different automatic bolus tracking thresholds for 64-slice spiral CT angiography in pulmonary artery[J]. Journal of Medical Imaging, 2015, 25(8): 1370−1376. (in Chinese).
|
| [16] |
CHATURVEDI A, THOMPSON J P, KAPROTH-JOSLIN K, et al. Identification of left ventricle failure on pulmonary artery CTA: Diagnostic significance of decreased aortic & left ventricle enhancement[J]. Emergency Radiology, 2017, 24(5): 1−10. DOI: 10.1007/s10140-017-1494-6.
|
| [17] |
张文明, 陈彬, 胡吉波, 等. 比较团注对比剂跟踪技术和小剂量团注测试技术在双能量CT肺灌注扫描中的应用[J]. 中华放射学杂志, 2013, 10(47): 892−897.
ZHANG W M, CHEN B, HU J B, et al. Comparison of test bolus and bolus tracking techniques for dual-energy CT lung perfusion scan[J]. Chinese Journal of Radiology, 2013, 10(47): 892−897. (in Chinese).
|
| [18] |
JAMALI L, ALIKHANI B, GETZIN T, et al. Arterial attenuation in individualized computed tomography pulmonary angiography injection protocol adjusted based on the patient's body mass index[J]. Journal of Research in Medical Sciences, 2020, 25: 94. DOI: 10.4103/jrms.JRMS_690_19.
|
| [19] |
周平, 蔡庆, 沈玉英, 等. 小剂量团注椭圆区域检测对比剂峰值法在肺动脉CTA检查中的应用价值[J]. 中国CT和MRI杂志, 2018, 16(12): 59−61. DOI: 10.3969/j.issn.1672-5131.2018.12.019.
ZHOU P, CAI P, SHEN Y Y, et al. Application value of contrast agent peak value method for test bolus ellipsometry in pulmonary artery CTA examination[J]. Chinese Journal of CT and MRI, 2018, 16(12): 59−61. DOI: 10.3969/j.issn.1672-5131.2018.12.019. (in Chinese).
|
| [20] |
LISELOTTE V D P, TROMEUR C, FABER L, et al. Chest X-ray not routinely indicated prior to the years algorithm in the diagnostic management of suspected pulmonary embolism[J]. TH Open, 2019, 03(1): 22−27. DOI: 10.1055/s-0038-1676812.
|
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