D. Grönemeyer, B. Brandts, C. Lehrenfeld, Frauke Metz, M. Garmer, O. Klein-Wiele
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引用次数: 0
摘要
心脏CT的辐射剂量似乎被低估了。利用噪声阈值确定冠状动脉钙(CAC)评分迭代重建对假阳性病变和辐射剂量的影响。基于噪声的阈值先前已被建议在低剂量方案中减少假阳性病变。在388对匹配的患者中,我们使用标准剂量过滤反向投影(FBP)和低剂量迭代重建(IR)的320排ct扫描仪进行CAC评分。剂量调制是基于噪声阈值。获得辐射剂量、图像质量和假阳性钙化程度。与FBP相比,IR显示剂量长度乘积减少(中位数61比74;p< 0.001),噪声较小(SD中位数14.71 vs 18.07;P < 0.001)和更高的信噪比(中位数4.01 vs 3.14;p < 0.001)。在388例患者中,IR检出低量钙化302例,中等量76例,高量10例,而FBP检出相应的分布分别为79例、175例和134例(p<0.001)。在这个临床环境中,我们证实了一项幻影研究的观察结果,即使用迭代重建和噪声阈值的CAC评分对于降低辐射剂量是有效的。
False-Positive Calcifications and Radiation Dose in Coronary Artery Calcium Scoring Using Iterative Reconstruction on The Basis of a Noise Threshold
Radiation dose from cardiac CT seems to be underestimated. To determine the effect of iterative reconstruction in coronary artery calcium (CAC) scoring on false positive lesions and radiation dose using a noise threshold. Noise-based thresholds have been previously suggested to reduce false positive lesions in lower dose protocols. In 388 matched pairs of patients we performed CAC scoring using a 320-row CT-scanner with standard dose filtered backprojection (FBP) and lower dose iterative reconstruction (IR). Dose modulation was based on a noise threshold. Radiation dose, image quality and extent of false-positive calcifications were obtained. IR versus FBP showed a reduced dose length product (median 61 versus 74; p< 0.001), less noise (median SD 14.71 versus 18.07; p< 0.001) and higher signal-to-noise ratio (median 4.01 versus 3.14; p< 0.001). Using IR in 388 patients, a low quantity of false-positive calcifications was found in 302 patients, a moderate quantity in 76 patients and a high quantity in 10 patients, while using FBP, the corresponding distribution of patients was 79, 175 and 134 (p<0.001). In this clinical setting we confirm the observation of a phantom study that CAC scoring using iterative reconstruction and a noise threshold is effective for the reduction of radiation dose.