本文選題：冠狀動脈血管　切入點：體層攝影術(shù)　出處：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景冠狀動脈CT血管成像(CCTA)在當今已經(jīng)大范圍地被運用于冠狀動脈疾病的診斷與研究之中,在目前設(shè)備的時間及空間分辨率和成像圖像重建算法在不斷提高的大時代背景下,冠狀動脈CTA圖像成像的心動偽影依然存在著,對現(xiàn)行臨床學(xué)診斷研究產(chǎn)生誤差,這個是個比較棘手的問題確實存在著[1]。其中運動偽影的影響比心率影響更為顯著,冠狀動脈運動追蹤技術(shù)(Snapshot freeze,SSF)是多層螺旋CT64排CT時代硬件及軟件設(shè)備不斷發(fā)展過程中所衍生成出來的新的產(chǎn)物,是心動運動的偽影圖像后處理的計算機新重建算法,冠狀動脈運動追蹤技術(shù)SSF全面了相鄰一個周期的心動圖像信息資源來填補虛化的有斷層的待觀察的目標冠狀動脈運動圖像的軌跡,獲得校正該目標血管運動成像的偽影,凍結(jié)冠狀動脈的結(jié)果[2]。目的探討能譜CT結(jié)合運動追蹤凍結(jié)技術(shù)在冠狀動脈CT血管成像(CCTA)65%時相下對不同CT值的圖像去除運動偽影能力的研究,評價冠狀動脈運動追蹤技術(shù)(SSF算法)去除心動運動圖像成像偽影后處理的臨床應(yīng)用價值與意義。方法選取30例患者,均進行最新一代寶石能譜前瞻性心電門控心臟多層螺旋CT(MSCT模式)掃描。平均年齡為56.3±11.4歲,男性13人,女性17人。按照CT值100,200,300,400,500HU分為A、B、C、D和E五組。對比劑注射流量標準為200mgI/kg,注射時流率為注射流量除以12秒。所有原始圖像都重建65%的時相,加40%ASIR的迭代算法,均進行標準算法(STD)和冠狀動脈運動追蹤技術(shù)(SSF)兩種方法重建。由2名醫(yī)師分別對LM,LAD-p,LAD-m,LAD-d,D1,D2,LCX-p,LCX-m,LCX-d,LMB,RCA-p,RCA-m,RCA-d和PDA14個分支血管的標準算法(STD)和冠狀動脈運動追蹤技術(shù)(SSF)兩種算法進行主觀評分,采用5分制法。測量動脈主根部CT值和噪聲同時測量心肌包脂肪CT值及噪聲。計算信噪比(SNR)和對比噪聲比(CNR),進行客觀評價。采用單因素方差分析比較其客觀性存在的差異;采用Wilcoxon檢驗比較兩種算法主觀性的差異。結(jié)果D組(CT值400HU)所得圖像信噪比(SNR)和對比噪聲比(CNR)分別為16.8±25,21.9±3.2,明顯高于其他四組。在14支分血管的標準算法(STD)主觀評分均低于冠狀動脈運動追蹤技術(shù)(SSF算法),p0.05有差異性存在且具有統(tǒng)計學(xué)意義。在D組(CT值400HU),LM,LAD-p,LAD-m,LAD-d,D1,D2,LCX-p,LCX-m,LCX-d,LMB,RCA-p,RCA-m,RCA-d,和PDA的冠狀動脈運動追蹤技術(shù)(SSF)組的主觀評分方面分別為(4.8±0.4,4.8±0.4,4.5±0.5,4.2±0.6,3.7±0.7,4.3±0.5,4.4±0.6,4.3±0.7,3.8±1,4.1±0.8,4.5±0.6,4.1±1,4.3±0.7,4.3±0.5),標準算法(STD)組分別為(4.7±0.4,4.6±0.6,4.4±0.5,3.8±0.7,3.3±1,3.9±0.7,4.1±0.7,3.8±1,3.4±1,3.9±0.9,3.7±0.9,2±1,3.5±1,4.2±0.2)。結(jié)論在65%重建時相下,能譜CT結(jié)合冠狀動脈運動追蹤技術(shù)(SSF算法)對冠狀動脈CT血管成像的圖像質(zhì)量有明顯的改善,最佳CT值為400HU。
[Abstract]:Background Coronary artery CT angiography (CCTAA) has been widely used in the diagnosis and research of coronary artery disease. Under the background of the time and spatial resolution of the equipment and the improvement of image reconstruction algorithm, CCTAs have been widely used in the diagnosis and research of coronary artery disease. The artifact of coronary artery CTA image still exists, and the error in the current clinical diagnosis research is quite difficult. [1] the effect of motion artifact is more significant than that of heart rate. The coronary artery motion tracking technique (Snapshot freezeFs) is a new product derived from the continuous development of hardware and software equipment in the era of multi-slice spiral CT64 slice CT, and is a new reconstruction algorithm for the post-processing of the artifact image of cardiac motion. The coronary artery motion tracking technique (SSF) provides a comprehensive information resource of the adjacent cycle of cardiac images to fill up the track of the phantom target coronary artery motion image with a fault to be observed, and obtain the artifact to correct the target vessel motion imaging. Objective to investigate the effect of energy dispersive CT (EDS) combined with motion tracking freezing technique on the removal of motion artifacts from different CT images at 65 hours after coronary CT angiography (CCTA). To evaluate the clinical application value and significance of coronary artery motion tracking technique (SSF algorithm) in removing artifact processing of cardiac motion image. Methods Thirty patients were selected. All patients were scanned with the latest generation of electrocardiogram (ECG) multilayer spiral CT(MSCT mode. The mean age was 56.3 鹵11.4 years old, 13 males, 13 males, and 56.3 鹵11.4 years old. 17 women were divided into five groups according to CT value 100200300400500HU. The standard of contrast medium injection flow was 200 mg I / kg, the flow rate at injection time was injection flow rate divided by 12 seconds. All the original images were reconstructed 65% of the time phase, and the iterative algorithm of 40%ASIR was added. Two methods, standard algorithm STD) and coronary artery tracking technique (SSF), were used to reconstruct the two methods. The two methods were evaluated by two physicians, namely, LML-LAD-pLAD-LAD-mAD-LAD-D _ 1D _ 2LCX-pCX _ (LX) LCX-dLMBN RCA-mRCA-d and the standard algorithm of RCA-mRCA-mRCA-d for each branch of PDA14, and the coronary artery tracking technique (SSF), respectively, for the purpose of subjective evaluation of the two algorithms, the two methods were used to evaluate the RCA-mRCA-d and the coronary artery tracking technique (SSF), respectively. The CT value of arterial root and noise were measured simultaneously, the SNR and the contrast noise ratio (CNRR) were calculated, and the objective evaluation was carried out. The objective difference was compared by single factor analysis of variance (ANOVA). Results the signal-to-noise ratio (SNR) and contrast noise ratio (RRR) of D group were 16.8 鹵251.90 鹵3.2, respectively, which were significantly higher than those of the other four groups. The subjective scores of the standard algorithm for 14 branches of blood vessels were all higher than that of the other four groups. In group D, there was a significant difference between the two groups (P < 0.05). In group D, the subjective score of RCA-pRCA-mRCA-mRCA-d0. 5 in group D was 4.8 鹵0. 44.8 鹵0. 44.5 鹵0. 54.5 鹵0. 64.43 鹵0. 64.3 鹵0. 64.3 鹵0. 64.3 鹵0. 64.3 鹵0. 64.1 鹵0. 74.1 鹵0. 84.1 鹵0. 64.1 鹵0. 64.1 鹵0. 64.1 鹵0. 64.1 鹵0. 74.3 鹵0. 74.3 鹵0. 74.3 鹵0. 74.3 鹵0. 74.3 鹵0. 74.3 鹵0. 74.3 鹵0. 74.3 鹵0. 74.30 鹵0. 74.30 鹵0. 64.30 鹵0. 64.40 鹵0. 64.30 鹵0. 64.40 鹵0. 64.40 鹵0. 54.40 鹵0. 44.5 鹵0. 44.5 鹵0. 44.5 鹵0. 44.5 鹵0. 64.40 鹵0. 64.40 鹵0. 64.30 鹵0. 64.43 鹵0. 64.30 鹵0. 64.34 鹵0. 54.@@. 4. 7 鹵0. 4, 4. 6 鹵0. 6N, 4. 4 鹵0. 5, 3. 8 鹵0. 7, 3. 3 鹵0. 7, 3. 3 鹵13. 9 鹵0. 7, 4. 8 鹵1. 4 鹵1. 4 鹵1. 4 鹵1. 9 鹵1. 9 鹵0. 9 鹵0. 9 鹵0. 9 鹵1. 9 鹵1. 5 鹵1. 2 鹵2. 2 鹵1. 5 鹵1. 2 鹵0. 2. Conclusion under 65% reconstruction phase, Energy dispersive CT (EDCT) combined with coronary motion tracking (SSF) improved the image quality of coronary artery CT angiography. The best CT value was 400HU.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R816.2

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