Abstract Objective: To investigate the clinical use of 256-slice spiral CT in the diagnosis of head and neck artery disease in CTA combined with low-tube-voltage and low rate injection of contrast medium by IMR reconstruction. Methods: Sixty patients who would perform head-neck CTA were enrolled and divided into two groups randomly. CTA was performed in group A using normal tube voltage(120 kV) and normal injection rate of contrast medium(5 mL/s) by iDose4 reconstruction. Group B received CTA by low-tube-voltage(100 kV) and low injection rate of contrast medium(4 mL/s) with IMR reconstruction. Quantitative measurements of CT value, image noise and contrast-to-noise ratio(CNR) were measured in either group. The t-test was used to compare objective evaluation indices(noise, CNR) and radiation dosage between the two groups. χ2-test was used to compare subjective evaluation of image quality(contrast, sharpness and subjective noise) between the two groups. A level of P＜0.05 was considered statistically significant. Results: There were significant differences in objective noise and CNR between the two groups(P＜0.01). Group B showed better subjective image quality. Compared to group A, group B showed better subjective scores of contrast and noise, and slightly worse score of sharpness with no significence(P>0.05). The effective dose(ED) of group B((0.84±0.03) mSv) was 41% lower compared to group A((1.43±0.06) mSv). Conclusion: Compared with iDose4, iterative model reconstruction technique can provide 41% ED reduction in head-neck CTA by 256 MSCT with satisfactory image quality.
GAO Si-zhe,ZHANG Bin,ZHAO Fu-xin, et al. Application in head-neck CTA based on IMR with low tube voltage and low rate injection of contrast medium[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(1): 64-67.
[1]缪妙，曹国全，邰云鹏，等. 迭代算法对CT低剂量扫描潜能的体模研究[J]. 温州医科大学学报，2015，45（11）：845－848．
[2]朱全东，窦娅芳，梁宗辉，等． 迭代重建技术在头颈部ＣＴ血管成像中的应用[J]． 中华放射学杂志，2013，47（4）：970-974.
[3]王敏，李剑． 低管电压在头颈部动脉成像中的可行性研究[J]． 临床放射学杂志，2013，32（11）：1662-1665．
[4]陈黎丽，潘为领，王学亭，等． 低剂量对比剂在256 层CT头颈部血管成像中的应用[J]． 医学影像学杂志，2013，23（5）：672-674.
[5]王建国，王振常，杨晓宇，等． 迭代重建技术与ＣＴ图像质量及辐射剂量的相关性研究[J]． 中华放射学杂志，2013，47（11）：980-983.
[6]李玮，刘建新，王霄英，等． 低电压、低对比剂剂量头颈CTA的可行性研究[J]． 放射学实践，2013，28（5）：482-485．
[7]Kondratyev E, Karmazanovsky G. Low radiation dose 256-MDCT angiography of the carotid arteries: effect of hybrid iterative reconstruction technique on noise, artifacts, and image quality[J]. Eur J Radiol, 2013, 82(12): 2233-2239.
[8]Kidoh MI, Nakaura T, Nakamura S, et al. Feasibility of low-radiation-dose CT for abdominal examinations with hybrid iterative reconstruction algorithm: low-contrast phantom study[J]. Clin Radiol, 2013, 68(10): 1008-1015.
[9]Mehta D, Thompson R, Morton T, et al. Iterative model reconstruction: simultaneously lowered computed tomography radiation dose and improved image quality[J]. Med Phys Int, 2013, 2: 147-155.
[10]Nakaura T, Iyama Y, Kidoh M, et al. Comparison of iterative model, hybrid iterative, and filtered back projection reconstruction techniques in low-dose brain CT: impact of thin-slice imaging[J]. Neuroradiology, 2016, 58(3): 245-251.
[11]Park SB, Kim YS, Lee JB, et al. Knowledge-based iterative model reconstruction(IMR) algorithm in ultralow-dose CT for evaluation of urolithiasis: evaluation of radiation dose reduction, image quality, and diagnostic performance[J]. Abdom Imaging, 2015, 40(8): 3137-3146.
[12]Park CH, Lee J, Oh C, et al. The feasibility of sub-millisievert coronary CT angiography with low tube voltage, prospective ECG gating, and a knowledge-based iterative model reconstruction algorithm[J]. Int J Cardiovasc Imaging, 2015, 31(Suppl 2): 197-203.
[13]Itatani R, Oda S, Utsunomiya D, et al. Reduction in radiation and contrast medium dose via optimization of low-kilovoltage CT protocols using a hybrid iterative reconstruction algorithm at 256-slice body CT: Phantom study and clinical correlation[J]. Clin Radiol, 2013, 68(3): e128-135.
[14]胡莹莹，孙宏亮，王玉丽，等. 采用低管电压技术和低剂量对比剂行256层螺旋CT头颈部动脉成像的可行性[J]. 中国医学影像技术，2012，28（7）：1396-1400.
[15]Noel PB, K?觟hler T, Fingerle AA, et al. Evaluation of an iterative model-based reconstruction algorithm for low-tube-voltage(80 kVp) computed tomography angiography[J]. J Med Imaging(Bellingham), 2014, 1(3): 033501.
[16]Iyama Y, Nakaura T, Yokoyama K, et al. Impact of knowledge-based iterative model reconstruction in abdominal dynamic CT with low tube voltage and low contrast dose[J]. AJR, 2016, 206(4): 687-693.
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