60kVp管电压联合人工智能迭代重建在头颈CTA中的应用价值OA
Application value of 60 kVp tube voltage combined with artificial intelligence iterative reconstruction in head and neck CT angiography
目的 探讨60 kVp超低管电压联合人工智能迭代重建(AIIR)在头颈动脉CT血管成像(CTA)中的可行性.方法 前瞻性纳入120例行头颈动脉CTA检查的病人,随机分为4组(每组30例):A组[100 kVp、40 mL对比剂、混合迭代重建(HIR)]、B组(80 kVp、40 mL对比剂、HIR)、C组(60 kVp、40 mL对比剂、AIIR 3、4级重建,分为C3、C4组)和D组(60 kVp、20 mL对比剂、AIIR 3、4级重建,分为D3、D4组).比较各组主观影像质量评分(5分法)、客观参数[噪声、信噪比(SNR)、对比噪声比(CNR)]及辐射剂量[CT剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效剂量(ED)].以数字减影血管造影(DSA)为金标准评估诊断准确性.采用单因素方差分析或Kruskal-Wallis检验比较计量资料,卡方检验比较计数资料.采用Cohen's Kappa检验评估一致性.结果 4组病人的基线数据均衡(均P>0.05).各组主观影像质量评分均≥3分,组间差异无统计学意义(均P>0.05),阅片者间一致性良好(均κ≥0.675).与A组相比,C3、C4、D3和D4组噪声均显著降低(均P<0.05),SNR和CNR均显著升高(均P<0.05),而A、B组间差异无统计学意义(P>0.05).低剂量各组的平均CT值与A组的相当或显著增高.4组中有13例进行了DSA检查,其结果对照显示各组CTA的诊断准确度均为 100%.与A组相比,B、C、D组的辐射剂量分别降低了 44.7%、77.3%和77.3%.结论 60 kVp联合AIIR的头颈动脉CTA方案可在辐射剂量降低77%、对比剂减少50%的条件下维持诊断级影像质量.
Objective To investigate the feasibility of 60 kVp ultra-low tube voltage combined with artificial intelligence iterative reconstruction(AIIR)in head and neck CT angiography(CTA).Methods A total of 120 patients undergoing head and neck CTA were prospectively enrolled and randomly divided into 4 groups(30 cases per group):Group A[100 kVp,40 mL contrast agent,hybrid iterative reconstruction(HIR)],Group B(80 kVp,40 mL contrast agent,HIR),Group C(60 kVp,40 mL contrast agent,AIIR level 3 and 4,recorded as C3 and C4),and Group D(60 kVp,20 mL contrast agent,AIIR level 3 and 4,recorded as D3 and D4).Subjective image quality scores(5-point scale),objective parameters[noise,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)],radiation dose[CT dose index(CTDIvol),dose-length product(DLP),and effective dose(ED)]were compared among groups.Diagnostic accuracy was assessed using digital subtraction angiography(DSA)as the reference standard.Continuous variables were analyzed using one-way ANOVA or the Kruskal-Wallis test,categorical variables using the chi-square test,and interobserver agreement was assessed using Cohen's Kappa test.Results Baseline characteristics were well balanced among the 4 groups(all P>0.05).The subjective image quality scores were≥3 in all groups,with no significant differences among groups(all P>0.05),and inter-reader agreement was good(all κ≥0.675).Compared with Group A,image noise was significantly reduced in Group C3,C4,D3,and D4(all P<0.05).while SNR and CNR were significantly increased(all P<0.05).No significant difference was found between Groups B and A(P>0.05).The mean CT values in the low-dose groups were comparable to or significantly higher than those in Group A.Thirteen patients underwent DSA examination,and comparison with DSA demonstrated a diagnostic accuracy of 100%for CTA in all groups.Compared with Group A,radiation dose was reduced by 44.7%,77.3%,and 77.3%in Groups B,C,and D,respectively.Conclusion The 60 kVp head and neck CTA protocol combined with AIIR can maintain diagnostic-level image quality while reducing radiation dose by 77%and contrast agent volume by 50%.
赵敏捷;周长圣;鲍雪芹;伊东娜;廖安宇;朱武生;程晓青;张龙江
南京大学医学院附属金陵医院放射诊断科,南京 210002南京大学医学院附属金陵医院放射诊断科,南京 210002南京大学医学院附属金陵医院放射诊断科,南京 210002南京大学医学院附属金陵医院放射诊断科,南京 210002南京大学医学院附属金陵医院神经内科南京大学医学院附属金陵医院神经内科南京大学医学院附属金陵医院放射诊断科,南京 210002南京大学医学院附属金陵医院放射诊断科,南京 210002
医药卫生
低剂量体层摄影术,X线计算机头颈动脉CT血管成像辐射剂量人工智能迭代重建
Low-doseTomography,X-ray computedHead and neck CT angiographyRadiation doseArtificial intelligence iterative reconstruction
《国际医学放射学杂志》 2026 (2)
125-130,6
国家自然科学基金重点项目(82230068)国家自然科学基金项目(82271983)
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