背景:高分辨率计算机断层扫描(HRCT)在间质性肺疾病的诊断评估中依赖于详细的形态学。光子计数CT(PCCT)可以提高分辨率,同时减少辐射。
目的:比较图像质量,详细的形态学,与能量整合CT(EICT)相比,PCCT改善了肺部HRCT中的辐射剂量。
方法:HRCT与PCCT在体重指数(BMI)从正常到肥胖的患者中,包括以前用不同的EICT检查的。根据CT的质量标准(ImPACT组的诊断要求-欧洲标准化),对图像质量进行了五步评估。此外,毛玻璃不透明,支气管扩张,肺气肿,结节,和胸膜下的详细形态(距离胸膜边界≤1cm)由3名独立的胸部和/或儿科放射科医师进行评估.视觉分级特征(VGC)用于比较图像质量和详细形态以及Fleisskappa的观察者内部变异性。收集剂量长度乘积(DLP)和CT剂量指数体积(CTDIvol)以计算有效辐射剂量。
结果:52名女性和48名男性(平均年龄=67.2±13.6岁;年龄范围=27-87岁;BMI=26.9kg/m2;范围=18.6-45kg/m2)先前使用EICT检查过(平均年龄=65.3±13.6岁;年龄范围=27-85岁;BMI=27kg/m2;范围=18.9-45kg/m2)。所有实体的图像质量均存在显着差异,有利于PCCT。PCCT的辐射剂量总共减少了47%,肥胖者占48.5%。
结论:图像质量,详细的形态学,和辐射剂量,特别是肥胖患者,与常规EICT相比,PCCT的HRCT显着改善。这项新技术可以可视化胸膜下结构。
BACKGROUND: High-resolution computed tomography (HRCT) is dependent on detailed morphology in diagnostic assessment of interstitial lung diseases. Photon-counting CT (PCCT) enables improved resolution while reducing radiation.
OBJECTIVE: To compare if the image quality, detailed morphology, and radiation dose in HRCT of the lung improves with PCCT compared to energy-integrated CT (EICT).
METHODS: HRCT with PCCT in patients with body mass index (BMI) from normal to obese, previously examined with different EICT were included. They were evaluated in a five-step scale for image quality according to Quality Criteria for CT (Diagnostic Requirement of the ImPACT group-European standardization). In addition, ground-glass opacities, bronchiectasis, emphysema, nodules, and subpleural detailed morphology (≤1 cm from the pleural border) were evaluated by three independent thoracic and/or pediatric radiologists. Visual grading characteristics (VGC) were used for comparison of image quality and detailed morphology and Fleiss kappa for intra-observer variability. Dose-length product (DLP) and CT dose index-volume (CTDIvol) were collected to calculate effective radiation dose.
RESULTS: HRCT with PCCT in 52 women and 48 men (mean age=67.2 ± 13.6 years; age range=27-87 years; BMI=26.9 kg/m2; range=18.6-45 kg/m2) previously examined with EICT (mean age=65.3 ± 13.6 years; age range=27-85 years; BMI=27 kg/m2; range=18.9-45 kg/m2) were included. There were significant differences in image quality for all entities in favor of PCCT. The radiation dose was reduced with PCCT by 47% in all, particularly pronounced in obese with 48.5%.
CONCLUSIONS: Image quality, detailed morphology, and radiation dose, particularly in obese patients, were significantly improved in HRCT with PCCT compared to conventional EICT. The new technique enables visualization of subpleural structures.