背景:应更新定量冠状动脉钙(CAC)的参考方案,以满足现代成像技术的标准。
目的:为了评估滤波反投影(FBP)的影响,混合迭代重建(IR),以及体外和体内研究中CAC定量的三个层次的深度学习重建(DLR)。
方法:使用多功能拟人化的胸部模型和小块骨头进行体外研究。使用水置换法测量每片的实际体积。在体内研究中,100名患者(84名男性;平均年龄=71.2±8.7岁)接受了CAC评分,管电压为120kVp,图像厚度为3mm。图像重建是用FBP完成的,混合IR,和三个水平的DLR,包括轻度(DLRmiline),标准(DLRstd),和强大(DLRstr)。
结果:在体外研究中,FBP之间的钙体积相等(P=0.949),混合IR,DLRmile,DLRstd,和DLRstr。在体内研究中,在使用基于DLRstr重建的图像中,图像噪声明显较低,当比较图像其他重建(P<0.001)。FBP之间的钙体积(P=0.987)和Agatston评分(P=0.991)没有显着差异。混合IR,DLRmile,DLRstd,和DLRstr。与标准FBP重建相比,在DLR组(98%)和混合IR(95%)中发现Agatston评分的总体一致性最高。
结论:DLRstr在Agatston评分中呈现最低的一致性偏倚,推荐用于CAC的准确量化。
BACKGROUND: The reference protocol for the quantification of coronary artery calcium (CAC) should be updated to meet the standards of modern imaging techniques.
OBJECTIVE: To assess the influence of filtered-back projection (FBP), hybrid iterative reconstruction (IR), and three levels of deep learning reconstruction (DLR) on CAC quantification on both in vitro and in vivo studies.
METHODS: In vitro study was performed with a multipurpose anthropomorphic chest phantom and small pieces of bones. The real volume of each piece was measured using the water displacement method. In the in vivo study, 100 patients (84 men; mean age = 71.2 ± 8.7 years) underwent CAC scoring with a tube voltage of 120 kVp and image thickness of 3 mm. The image reconstruction was done with FBP, hybrid IR, and three levels of DLR including mild (DLRmild), standard (DLRstd), and strong (DLRstr).
RESULTS: In the in vitro study, the calcium volume was equivalent (P = 0.949) among FBP, hybrid IR, DLRmild, DLRstd, and DLRstr. In the in vivo study, the image noise was significantly lower in images that used DLRstr-based reconstruction, when compared images other reconstructions (P < 0.001). There were no significant differences in the calcium volume (P = 0.987) and Agatston score (P = 0.991) among FBP, hybrid IR, DLRmild, DLRstd, and DLRstr. The highest overall agreement of Agatston scores was found in the DLR groups (98%) and hybrid IR (95%) when compared to standard FBP reconstruction.
CONCLUSIONS: The DLRstr presented the lowest bias of agreement in the Agatston scores and is recommended for the accurate quantification of CAC.