在主动脉 CT 血管造影中,多能量低千伏与单能量低千伏图像在内膜渗漏检测中的对比。

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-04-01 DOI:10.1148/ryct.230217
Anna Landsmann, Thomas Sartoretti, Victor Mergen, Lisa Jungblut, Matthias Eberhard, Adrian Kobe, Hatem Alkadhi, André Euler
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Contrast-to-noise ratio (CNR) was measured. Two expert radiologists established the reference standard for the presence of endoleaks. Detection and conspicuity of endoleaks and subjective image quality were assessed by two different blinded radiologists. Interreader agreement was calculated. Nonparametric statistical tests were used. Results A total of 125 participants (mean age, 76 years ± 8; 103 men) were allocated to groups A (<i>n</i> = 64) and B (<i>n</i> = 61). CNR was significantly lower for 40-keV VMI (mean, 19.1; <i>P</i> = .048) and 50-keV VMI (mean, 16.8; <i>P</i> < .001) as compared with SEI (mean, 22.2). In total, 45 endoleaks were present (A: 23 vs B: 22). Sensitivity for endoleak detection was higher for SEI (82.6%, 19 of 23; <i>P</i> = .88) and 50-keV VMI (81.8%, 18 of 22; <i>P</i> = .90) as compared with 40-keV VMI (77.3%, 17 of 22). 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引用次数: 0

摘要

目的 比较单能量和多能量图像在血管内主动脉修复术(EVAR)后 CT 血管造影(CTA)中用于内漏检测的图像质量、诊断性能和清晰度。材料与方法 在这项单中心前瞻性随机对照试验中,2020 年 8 月至 2022 年 5 月期间接受 EVAR 后 CTA 的患者被分配到使用低千伏单能图像(SEI;80 千伏,A 组)或多能 CT(80/Sn150 千伏,B 组)40 和 50 千伏的低千伏虚拟单能图像(VMI)进行成像。扫描方案剂量匹配(容积 CT 剂量指数:平均值 4.5 mGy ± 1.8 [SD] vs 4.7 mGy ± 1.3,P = .41)。测量对比度与噪声比(CNR)。两位放射科专家确定了是否存在内漏的参考标准。由两名不同的盲人放射科医生对内膜漏的检测和明显程度以及主观图像质量进行评估。计算读片者之间的一致性。采用非参数统计检验。结果 共有 125 名参与者(平均年龄 76 岁 ± 8 岁;103 名男性)被分配到 A 组(64 人)和 B 组(61 人)。与 SEI(平均值为 22.2)相比,40-keV VMI(平均值为 19.1;P = .048)和 50-keV VMI(平均值为 16.8;P < .001)的 CNR 明显较低。共有 45 个内漏(A:23 个;B:22 个)。与 40-keV VMI(77.3%,22 人中有 17 人)相比,SEI(82.6%,23 人中有 19 人;P = .88)和 50-keV VMI(81.8%,22 人中有 18 人;P = .90)的内漏检测灵敏度更高。各组的特异性相当(SEI:92.7%,41 组中的 38 组;两种 VMI 能量:92.3%,38 组中的 35 组;P = .99),读片者之间的一致性为 1。SEI(中位数,2.99)和 VMI(两种能量:中位数,2.87;P = .04)的内漏明显度相当。与 40 和 50 keV(两种能量:中位数均为 4 [IQR,3-4];P < .001)相比,SEI 的整体主观图像质量评分明显更高(中位数为 4 [IQR,4-4])。结论 SEI 与 50-keV VMI 相比,在 EVAR 后的 CTA 内漏检测中显示出更高的图像质量和相当的诊断准确性。关键词动脉瘤、CT、CT 血管造影、血管、主动脉、技术评估、多载体 CT、腹主动脉瘤、内漏、移植物周围漏 本文有补充材料。© RSNA, 2024.
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Multi-Energy Low-Kiloelectron Volt versus Single-Energy Low-Kilovolt Images for Endoleak Detection at CT Angiography of the Aorta.

Purpose To compare image quality, diagnostic performance, and conspicuity between single-energy and multi-energy images for endoleak detection at CT angiography (CTA) after endovascular aortic repair (EVAR). Materials and Methods In this single-center prospective randomized controlled trial, individuals undergoing CTA after EVAR between August 2020 and May 2022 were allocated to imaging using either low-kilovolt single-energy images (SEI; 80 kV, group A) or low-kiloelectron volt virtual monoenergetic images (VMI) at 40 and 50 keV from multi-energy CT (80/Sn150 kV, group B). Scan protocols were dose matched (volume CT dose index: mean, 4.5 mGy ± 1.8 [SD] vs 4.7 mGy ± 1.3, P = .41). Contrast-to-noise ratio (CNR) was measured. Two expert radiologists established the reference standard for the presence of endoleaks. Detection and conspicuity of endoleaks and subjective image quality were assessed by two different blinded radiologists. Interreader agreement was calculated. Nonparametric statistical tests were used. Results A total of 125 participants (mean age, 76 years ± 8; 103 men) were allocated to groups A (n = 64) and B (n = 61). CNR was significantly lower for 40-keV VMI (mean, 19.1; P = .048) and 50-keV VMI (mean, 16.8; P < .001) as compared with SEI (mean, 22.2). In total, 45 endoleaks were present (A: 23 vs B: 22). Sensitivity for endoleak detection was higher for SEI (82.6%, 19 of 23; P = .88) and 50-keV VMI (81.8%, 18 of 22; P = .90) as compared with 40-keV VMI (77.3%, 17 of 22). Specificity was comparable among groups (SEI: 92.7%, 38 of 41; both VMI energies: 92.3%, 35 of 38; P = .99), with an interreader agreement of 1. Conspicuity of endoleaks was comparable between SEI (median, 2.99) and VMI (both energies: median, 2.87; P = .04). Overall subjective image quality was rated significantly higher for SEI (median, 4 [IQR, 4-4) as compared with 40 and 50 keV (both energies: median, 4 [IQR, 3-4]; P < .001). Conclusion SEI demonstrated higher image quality and comparable diagnostic accuracy as compared with 50-keV VMI for endoleak detection at CTA after EVAR. Keywords: Aneurysms, CT, CT Angiography, Vascular, Aorta, Technology Assessment, Multidetector CT, Abdominal Aortic Aneurysms, Endoleaks, Perigraft Leak Supplemental material is available for this article. © RSNA, 2024.

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