单能量去金属伪影技术在脑动脉瘤术后中的应用价值

doi:DOI:10.12117/jccmi.2018.12.004

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摘要目的：评价单能量去金属伪影技术（SEMAR）对颅内动脉瘤栓塞及夹闭术后金属伪影和灌注参数的影响。方法：55例颅内动脉瘤栓塞或夹闭术后患者，均行320排CTA+灌注一站式检查。扫描后首先用第三代适应性迭代降噪算法（AIDR 3D）单独重建成No-SEMAR组，再用SEMAR加AIDR 3D算法重建成SEMAR组。分别对比两组金属伪影周围的噪声、对比噪声比（CNR）、伪影指数（AI）、伪影的最大直径、图像质量主观评分和灌注参数。结果：与No-SEMAR组相比，SEMAR组噪声、伪影最大直径、AI明显减低（P<0.01），图像质量主观评分和CNR明显增高（P<0.01）。两组得到的灌注参数脑血流量（CBF）、脑血容量（CBV）、平均通过时间（MTT）线性相关性良好（P<0.01）。结论：SEMAR技术可以明显减少颅内动脉瘤金属植入物的伪影，能在不影响脑CT灌注参数的情况下，提高图像质量。

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	冉彦永1
	潘宇宁2
	陈兆乾2
	黄求理2

关键词 ：颅内动脉瘤, 体层摄影术, X线计算机

Abstract：Objective: To evaluate the effect of a single-energy metal artifact reduction(SEMAR) technique for metallic implantation materials artifacts reduction and perfusion parameters in brain imaging. Methods: Computed tomography angiography(CTA) and CT perfusion were performed on 55 patients with implanted metallic materials in the brain. All CT examinations were performed on a 320-row CT scanner. No-SEMAR images were reconstructed with iterative reconstruction alone, and SEMAR images were reconstructed with iterative reconstruction plus the SEMAR algorithm. Noise(N-measured on the image with the most pronounced artifact), contrast-to-noise ratio(CNR), artifact index(AI), maximum diameter of artifact, image quality score, and cerebral perfusion parameters were compared between the two groups. Two radiologists visually evaluated the metallic artifacts using a four-point scale and a double blind method. Results: Compared with No-SEMAR images, noise, artifact diameter, and artifact index were reduced significantly after images were reconstructed using the SEMAR algorithm(P<0.01). The subjective image quality score and contrast-to-noise ratio increased significantly(P<0.01). The perfusion parameters(blood flow, blood volume, and mean transit time) obtained between the No-SEMAR and SEMAR groups exhibited linear correlation(P<0.01). Conclusion: The SEMAR algorithm significantly reduces artifact from implanted metallic materials in the brain and can potentially increase CT image quality without influencing cerebral blood perfusion parameters.

Key words： Intracranial aneurysm Tomography, X-ray computed

收稿日期: 2017-12-31

PACS:	Ｒ739.41
	Ｒ814.42

基金资助:浙江省医药卫生科研项目（2018KY155）；宁波市科技局科技惠民项目（2016C51013）；宁波市自然科学基金项目（2016A610140）；宁波市医疗卫生品牌学科项目（PPXK2018-04）。

通讯作者: 潘宇宁，宁波市第一医院影像科，315010。

作者简介: 冉彦永（1973-），男，浙江人，主治医师。

引用本文:

冉彦永1，潘宇宁2，陈兆乾2，黄求理2. 单能量去金属伪影技术在脑动脉瘤术后中的应用价值[J]. 中国临床医学影像杂志, 2018, 29(12): 852-856.
RAN Yan-yong1, PAN Yu-ning2, CHEN Zhao-qian2, HUANG Qiu-li2. The application value of single energy metal artifact reduction technique in the follow-up of postoperative patients with intracranial aneurysms. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(12): 852-856.

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http://www.jccmi.com.cn/CN/DOI:10.12117/jccmi.2018.12.004 或 http://www.jccmi.com.cn/CN/Y2018/V29/I12/852

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