| 寿蓓丽,李静,张文明,陈彬,张月俏,胡红杰.低管电压及对比剂用量结合深度学习全模型迭代算法用于上肢CT血管成像显示动静脉瘘[J].中国医学影像技术,2025,41(4):543~547 |
| 低管电压及对比剂用量结合深度学习全模型迭代算法用于上肢CT血管成像显示动静脉瘘 |
| Low tube voltage and low dose contrast agents combined with artificial intelligence iterative reconstruction in upper limb CT angiography for displaying arteriovenous fistula |
| 投稿时间：2024-10-01 修订日期：2024-12-03 |
| DOI：10.13929/j.issn.1003-3289.2025.04.008 |
| 中文关键词: 动静脉瘘 CT血管成像 人工智能 辐射剂量 对比剂 前瞻性研究 |
| 英文关键词:internal arteriovenous fistula computed tomography angiography artificial intelligence radiation dosage contrast medium prospective studies |
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| 中文摘要: |
| 目的 观察低管电压及对比剂用量结合深度学习全模型迭代算法(AIIR)用于上肢CT血管成像(CTA)显示动静脉瘘(AVF)的价值。方法 前瞻性纳入65例临床疑诊AVF狭窄而接受上肢CTA检查的慢性肾衰竭患者,将其随机归入常规组(CD组,n=30)或低剂量组(LD组,n=35)。对CD组采用常规管电压(100 kVp)及对比剂用量(1.0 ml/kg体质量)采集CTA,并以常规混合迭代重建(HIR)获得A组图像;对LD组以低管电压(80 kVp)及对比剂用量(0.6 ml/kg体质量)采集CTA,分别以HIR和AIIR重建获得B及C组图像。比较A、B、C组图像质量主观、客观评价结果,以及CD与LD组患者辐射剂量及对比剂用量。结果 A、C组间图像质量主观评分和诊断瘘口狭窄信心差异均无统计学意义(P均＞0.017)而均优于B组(P均＜0.017)。C组锁骨下动脉、肱动脉及桡动脉信噪比(SNR)和对比度噪声比(CNR)均高于A、B组(P均＜0.017);A、B组差异均无统计学意义(P均＞0.017)。低剂量组容积CT剂量指数、剂量长度乘积及对比剂用量均低于常规组(P均＜0.001)。结论 低管电压及对比剂用量联合AIIR用于上肢CTA显示AVF可在保证图像质量的同时降低辐射剂量和对比剂用量。 |
| 英文摘要: |
| Objective To investigate the value of low tube voltage and low dose contrast agents combined with artificial intelligence iterative reconstruction (AIIR) in upper limb CT angiography (CTA) for displaying arteriovenous fistula (AVF). Methods Totally 65 patients with chronic renal failure and suspected AVF stenosis who underwent upper limb CTA were prospectively enrolled and randomly divided into conventional-dose group (CD group, n=30) and low-dose group (LD group, n=35). In CD group, CTA was acquired using conventional tube voltage (100 kVp) and contrast agents dosage (1.0 ml/kg body mass), and conventional hybrid iterative reconstruction (HIR) was used to reconstruct images (group A), while in LD group, CTA was collected using 80 kVp and contrast agent dosage of 0.6 ml/kg body mass, and images were reconstructed with HIR (group B) and AIIR (group C), respectively. Then subjective and objective assessment of imaging quality were performed, respectively, the results were compared among groups, while the radiation dose and dosage of contrast agents were compared between CD and LD groups. Results No significant difference of subjective score of imaging quality nor confidence for diagnosing AVF stenosis was found between group A and group C (both P＞0.017), and all the above scores were higher than those in group B (all P＜0.017). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of subclavian artery, brachial artery and radial artery in group C were all higher than those in groups A and B (all P＜0.017), while no significant difference of SNR nor CNR was found between group A and B (all P＞0.017). The volume CT dose index, dose length product and dosage of contrast agent in LD group were all lower than those in CD group (all P＜0.001). Conclusion Low tube voltage and low dose contrast agents combined with AIIR in upper limb CTA for displaying AVF could reduce radiation dose and contrast agents dosage under the condition of ensuring imaging quality. |
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