1. Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China丨
2. Department of Medical Imaging Technology, Chongqing Medical University, Chongqing 400010, China
Abstract：Objective To explore the clinical value of dual-energy CT virtual monoenergetic imaging plus (VMI+) technology
combined with artificial intelligence (AI) in the diagnosis of intracranial aneurysms in head and neck CT angiography (CTA).
Methods A total of 41 cases of head and neck CTA data with clinical diagnosis as suspected intracranial aneurysms in our hospital
were reconstructed and we got 1 set of standard linear fusion (F_0.6) images and 9 sets of VMI+ (virtual energy level of 40~120 keV, interval
of 10 keV) images. We measured the CT value of arterial vessels and image noise at the bifurcation of the common carotid artery
in the 10 sets of images, calculated the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and compared the differences
of standard linear fusion (F_0.6) and VMI+ images. Based on the consistent diagnosis opinions of two senior physicians as the
reference standard, the diagnostic coincidence rate of intracranial aneurysms by AI at different energy levels was evaluated and screen
out the best diagnostic energy level. Results The diagnostic coincidence rates of AI in 40 keV group, 110 keV group and 120 keV group
were 51%, 64% and 60%, respectively. Compared with senior doctors, the above differences were statistically significant (P<0.05).
The coincidence rates of 50~100 keV and F_0.6 groups were 78%, 73%, 76%, 71%, 76%, 64% and 71% respectively (P>0.05).
Compared with senior doctors, the above differences were not statistically significant (P>0.05), and the area under ROC curve was
the largest at 50 keV (0.796, P=0.001). Compared with F_0.6 group, the CT values, SNR and CNR of the 40 keV and 50 keV groups
in the VMI+ image were significantly higher than F_0.6 group, the 50 keV group were increased by 92.47%, 18.65% and 11.87%.
And those of the 70~120 keV groups were lower than F_0.6 group, and the differences were statistically significant (P<0.05). The
CT value of 60 keV group was significantly higher than F_0.6 group, the difference was statistically significant (P<0.05). But
there was no statistically significant difference in SNR and CNR between F_0.6 group (P=0.084, 0.399). Conclusion AI assisted
diagnosis system has a high diagnostic coincidence rate for intracranial aneurysms. Virtual monoenergetic imaging plus technology can ensure the effective diagnosis of aneurysms by AI in the range of 50~100 keV energy level. Low-energy level reconstruction can
significantly improve the image quality of CTA images. The best energy level is recommended to be 50 keV.
韦鑫1，陈维娟1，邓昊1，余菡1，曹闻挺1，陈金华1，刘杨2. VMI+联合人工智能辅助诊断系统对颅内动脉瘤诊断价值的研究[J]. 中国医疗设备, 2021, 36(10): 100-103.
WEI Xin1，CHEN Weijuan1，DENG Hao1，YU Han1，CAO Wenting1，CHEN Jinhua1，LIU Yang2. Research of Dual Energy CT VMI+ Technology Combined
with Artificial Intelligence-Assisted Diagnosis System in the Diagnosis
of Intracranial Aneurysm. China Medical Devices, 2021, 36(10): 100-103.
