在CT衍生的左心室射出小部分中降低剂量的潜力:模拟研究
Martin Weber Kusk1,2,3, Søren Hess2,3,4, Oke Gerke4,5
1Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4 Belfield, Ireland.
概括
将CT辐射剂量减少20倍,可以准确测量左心室喷射率 (LVEF),这对于心力衰竭检测至关重要. 除了乳头肌肉外,可确保可靠的LVEF评估,辐射暴露最小.
科学领域:
- 医疗成像医学成像
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 左心室喷射分数 (LVEF) 对于诊断心力衰竭至关重要,特别是在心脏毒性化疗期间.
- 心脏MRI是黄金标准,但面临着可访问性和患者特定的限制.
- CT提供精确度,用于LVEF测量与常规瘤扫描一起,但高辐射剂量是一个问题.
研究的目的:
- 为 LVEF 评估,研究 CT 中显著降低辐射剂量的可行性.
- 开发和验证用于低剂量CT成像的噪声模拟算法.
- 为了确定准确的LVEF测量,最低的可接受辐射剂量.
主要方法:
- 开发了一种噪音模拟算法,使用在13个剂量级别上扫描的人形心脏幻影.
- 代优化过的反向投影参数以保持图像质量.
- 追溯分析了51个临床CT冠状动脉动图,模拟剂量减少到25%,10%,5%和2%.
- 使用临床软件测量带有和没有乳头肌肉的LVEF,并通过布兰德-阿尔特曼分析与全剂量扫描进行比较.
主要成果:
- 除了乳头肌肉外,LVEF测量显示,与全剂量扫描相比,模拟剂量的25%,10%和5%没有显著偏差.
- 在排除乳头肌肉时,在2%的模拟剂量下观察到4.4%的显著偏差.
- 包括乳头肌肉导致所有模拟剂量水平的小但显著的偏差.
结论:
- 基于CT的LVEF测量是可行的,剂量减少高达20倍 (有效剂量为1mSv).
- 从LV体积中排除乳头肌肉对于在降低剂量时保持精度至关重要.
- 这种方法使得常规的瘤CT扫描能够在最小的额外辐射暴露下进行LVEF评估.
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