60kVp管电压联合心脏深度学习重建在小儿先天性心脏病CTA中的应用OA

Objective To investigate the feasibility of 60 kVp CT angiography(CTA)combined with a cardiac deep learning reconstruction algorithm(CardioBoost)for children with congenital heart disease(CHD).Methods A total of 160 children with clinically confirmed CHD who were scheduled for preoperative cardiac CTA were prospectively enrolled,with a median age of 8 months.The children were randomly assigned to a conventional-dose group and a low-dose group(80 patients in each group).In the conventional-dose group,hybrid iterative reconstruction(HIR)was used to generate Group A images(80 kVp,400 mA,HIR).In the low-dose group,HIR and CardioBoost reconstruction were used to produce Group B1 images(60 kVp,240 mA,HIR)and Group B2 images(60 kVp,240 mA,CardioBoost reconstruction),respectively.Radiation doses between the standard-dose and the low-dose groups were compared,including volume CT dose index(CTDIvol),dose-length product(DLP),effective dose(ED),and size-specific dose estimate(SSDE).The subjective image quality scores(5-point scale)and objective image quality parameters of each cardiac chamber and great vessel,including image noise,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR),were compared among Groups A,B1,and B2.Surgical findings were used as the gold standard to evaluate diagnostic accuracy.Quantitative data were compared using the Mann-Whitney U test and Kruskal-Wallis test,and categorical variables were compared using the chi-square test.Interobserver agreement between the two readers was assessed using Cohen's Kappa test.Results The ED in the low-dose group was reduced by 81.3%compared with that in the conventional-dose group(P<0.05).The interobserver agreement for the subjective image quality scoring was good across all three groups(all κ≥0.78).The subjective image quality scores were all≥3 in Groups A,B1,and B2.The subjective image quality score in Group B2 was significantly higher than that in Group B1(P<0.05),but did not differ significantly from that in Group A(P>0.05).Compared with Group B1,Group B2 showed reduced image noise and increased SNR and CNR(all P<0.05),and the objective image quality indices were comparable to or better than those of Group A.The diagnostic accuracy for intracardiac malformations in Group B2 was significantly higher than that in Group B1(P<0.05),but did not differ significantly from that in Group A(P>0.05).Conclusion For CTA in children with CHD,60 kVp combined with the CardioBoost algorithm can significantly reduce radiation dose while maintaining image quality comparable to that of the conventional-dose protocol.