全模型迭代重建技术（FIRST）在改善冠状动脉支架成像中的价值

doi:10.3969/j.issn.1674-1633.2021.11.016

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摘要目的探讨全模型迭代算法（Forward Projected Model-Based Iterative Reconstruction Solution，FIRST）在改善冠状动脉 CT血管造影（CT Angiography，CTA）支架成像质量中的价值。方法回顾性纳入于我院接受冠脉CTA检查的44例冠脉支架（59枚）置入术后患者。使用FIRST-Cardiac（FIRST-C），FIRST-Cardiac Sharp（FIRST-CS），混合迭代重建法（Adaptive Iterative Dose Reduction 3D，AIDR-3D）和滤波反投影法（Filtered Back Projection，FBP）四种算法重建图像。对所有图像行包括管腔信噪比（Signal-to-Noise Ratio，SNR）、对比噪声比（Contrast-to-Noise Ratio，CNR）、支架可见内径及支架内腔衰减率（Stent lumen Attenuation Increase Ratio，SAIR）等在内的客观评价，由2位医师采用5分值行双盲主观评分。比较四组图像间客观与主观评价的差异。结果图像质量客观分析显示，管腔SNR、CNR、支架可见内径和SAIR值在四组间差异均有统计学意义（P<0.001）。FIRST-C的管腔SNR、CNR显著优于其他三组（P<0.05）丨FIRST-CS组支架可见内径最大（1.96±0.42）mm，管腔衰减率最低0.32±0.27，优于其他三组。主观评分中，FIRST-C与FIRST-CS图像均满足诊断要求， FIRST-CS组评分最高，依次高于FIRST-C、AIDR-3D组和FBP组。结论与AIDR-3D、FBP相比，FIRST有助于改善冠脉支架图像质量，FIRST-C能有效提高管腔SNR，FIRST-CS在支架内腔可视化中更具优势，能为临床提供高质量图像。

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	曹立坤¹
	王怡宁¹
	易妍¹
	王沄¹
	马壮飞²
	闫静²
	付海鸿¹
	金征宇¹

Abstract：Objective To explore the potential of forward projected model-based iterative reconstruction solution (FIRST) in improving the image quality of coronary artery stents in CT angiography (CTA). Methods A total of 44 patients with 59 coronary stents who underwent coronary CTA in our hospital were included retrospectively. The images were reconstructed with FIRST-Cardiac (FIRST-C), FIRST-Cardiac Sharp (FIRST-CS), adaptive iterative dose reduction 3D (AIDR-3D) standard and filtered back projection (FBP) respectively. All images were evaluated objectively, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) of stent lumen, visible inner diameter of stent, and the stent lumen attenuation increase ratio (SAIR). Two radiologists visually evaluated the image quality of the stents and performed double-blind subjective scoring with 5-point scale (1=poor, 5=excellent). The difference between objective and subjective evaluation was compared between the four groups. Results Objective analysis of image quality showed that there were significant differences in SNR, CNR, visible inner diameter of stent and SAIR among these four groups (P<0.001). The SNR and CNR of FIRST-C group were significantly better than the other three groups (P<0.05)丨 the visible inner diameter of stent in the FIRST-CS group was the largest (1.96±0.42) mm, and the SAIR was the lowest 0.32±0.27, which was better than the other three groups. Among the subjective scores, FIRST-C and FIRST-CS images met the diagnostic requirements. The score of FIRST-CS group was the highest, which was sequentially higher than that of FIRST-C, AIDR-3D group and FBP group. Conclusion Compared with AIDR-3D and FBP, FIRST helps to improve the image quality of coronary stent. FIRST-C can effectively improve the SNR. FIRST-CS has more advantages in stent lumen visualization and can provide high-quality images for clinic

收稿日期: 2020-11-23

ZTFLH:

R543.3丨R814.42

通讯作者: 王怡宁 E-mail: wangyining@pumch.cn

引用本文:

曹立坤¹，王怡宁¹，易妍¹，王沄¹，马壮飞²，闫静²，付海鸿¹，金征宇¹. 全模型迭代重建技术（FIRST）在改善冠状动脉支架成像中的价值[J]. 中国医疗设备, 2021, 36(11): 71-75.
CAO Likun¹，WANG Yining¹，YI Yan¹，WANG Yun¹，MA Zhuangfei²，YAN Jing²，FU Haihong¹，JIN Zhengyu¹. Effect of the Forward Projected Model-Based Iterative Reconstruction Solution (FIRST) on Improving Image Quality of Coronary Artery Stent in Cardiac CT Angiography. China Medical Devices, 2021, 36(11): 71-75.

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http://cs.china-cmd.org/zgylsb/CN/10.3969/j.issn.1674-1633.2021.11.016 或 http://cs.china-cmd.org/zgylsb/CN/Y2021/V36/I11/71