最佳时相单扇区重建技术改善320排CT支气管动脉成像图像质量的可行性

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摘要目的：探讨320排CT最佳时相单扇区重建技术提高非预期自由呼吸患者支气管动脉及支气管动脉-肺动脉瘘检出能力的可行性。方法：2014年10月1日-2016年8月1日连续收集265例采用320层前瞻性心电门控动态容积CT行支气管动脉成像的患者，将其中55例存在严重移动伪影的多扇区重建图像进行二次单扇区重建，对比研究两种重建算法的成像效果及支气管动脉-肺动脉瘘检出量。用支气管动脉的显示等级（分1、2、3、4四个等级）量化来评价其图像质量。采用配对t检验比较两种重建图像支气管动脉平均CT值、图像噪声、信噪比及对比噪声比。结果：单扇区重建组各级分支显示的数量分别为1级164支（右83，左81）、2级177支（右92，左85）、3级170支（右114，左56）、4级94支（右76，左18），显著高于多扇区重建组的1级131支（右65，左66）、2级114支（右59，左55）、3级76支（右55，左21）、4级39支（右33，左6）。单扇区重建组检出16处支气管动脉-肺动脉瘘，显著高于多扇区重建组的的4处（P＜0.001）。单扇区重建组支气管动脉CT值、图像噪声均高于多扇区重建组（分别为373.3±61.0 vs. 331.2±65.0，17.3±2.4 vs. 14.0±2.3，P＜0.001），信噪比明显低于多扇区重建组（38.5±6.9 vs. 48.4±10.6，P＜0.001），两种重建算法在支气管动脉主干处的对比噪声比差异无统计学意义（P=0.322）。结论：最佳时相单扇区重建可改善高心率非预期自由呼吸患者支气管动脉图像移动伪影，显著提高支气管动脉细小分支的显示能力及支气管动脉-肺动脉瘘同步检出率。

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	王镇章
	郭献忠
	孙厚长
	曹国全
	毛丹丹
	张昭
	郑祥武
	陈伟建

关键词 ：体层摄影术, X线计算机；支气管动脉CT造影；单扇区重建；多扇区重建

Abstract：Objective: To assess the feasibility of the best phase half-cycle reconstruction in improving detection capability of bronchial artery and bronchial-pulmonary arterial fistulas for unanticipated free- breathing patients using 320-detector row dynamic volume CT. Methods: Fifty-five patients with severe motion artifacts during bronchial artery CTA were included in the study, who were scanned with prospective ECG-gating 320-detector row dynamic volume CT. All images were reconstructed with the best phase technique using half-cycle reconstruction (HCR) and multi-cycle reconstruction (MCR) methods.Wilcoxon signed-rank test was used to compare the grade (1, 2, 3, 4) of bronchial artery quantitative and paired t-test was used to compare the average CT values, noise (N), single to noise ratio (SNR), and contrast to noise ratio (CNR). Results: The number of bronchial artery branches at all grades from 1 grade to 4 grade in HCR group were 164, 177, 170, 94, respectively. It’s significantly greater than that in MCR group which were 131, 114, 76, 39, respectively. The bronchial artery CT values and noise in HCR group were greater than in that MCR group (respectively 373.3±61.0 vs. 331.2±65.0, 17.3±2.4 vs. 14.0±2.3, P<0.001). The SNR was significantly lower with HCR (38.5±6.9) than that with MCR (48.4±10.6, P<0.001). The CNRs had no significantly difference in the main segment of bronchial artery between the two groups (P=0.322). Conclusion: The best phase half-cycle reconstruction can improve image quality of bronchial artery CTA in high heart rates with unanticipated free-breathin, increase the number of tiny bronchial artery and bronchial-pulmonary arterial fistula significantly.

Key words： tomography, X-ray computed bronchial artery CT angiography half-cycle reconstruction multi-cycle reconstruction

收稿日期: 2017-02-24

基金资助:浙江省自然科学基金资助项目（Y17H180046）；温州市科技局科研基金资助项目（Y20150376）。

通讯作者: 陈伟建，教授，主任医师，硕士生导师，Email：wyyycwj@163．com

作者简介: 王镇章（1981-），男，浙江温州人，主管技师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I9/631

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