| 陶李娜,雷丽敏,周宇涵,郭晓旭,王亚婕,丁彦茹,岳松伟.虚拟单能成像联合去金属伪影技术用于改善颅内动脉瘤经弹簧圈栓塞后CT血管造影图像质量[J].中国介入影像与治疗学,2026,23(7):422-427 |
| 虚拟单能成像联合去金属伪影技术用于改善颅内动脉瘤经弹簧圈栓塞后CT血管造影图像质量 |
| Virtual monoenergetic imaging combined with metal artifact reduction technology for improving image quality of CT angiography for intracranial aneurysm after coil embolization |
| 投稿时间：2026-03-16 修订日期：2026-05-21 |
| DOI：10.13929/j.issn.1672-8475.2026.07.008 |
| 中文关键词: 颅内动脉瘤 伪影 深度学习图像重建算法 虚拟单能级图像 |
| 英文关键词:intracranial aneurysm artifacts deep learning image reconstruction virtual monoenergetic images |
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| 中文摘要: |
| 目的 观察基于深度学习图像重建（DLIR）算法的虚拟单能成像（VMI）（VMIDLIR）联合去金属伪影（MAR）技术改善颅内动脉瘤（ICA）经弹簧圈栓塞后CT血管造影（CTA）图像质量的价值。方法 前瞻性纳入44例拟接受金属弹簧圈栓塞的ICA，完成CTA后分别以50%强度自适应统计迭代重建（ASIR-V50%）、中等强度DLIR（DLIR-M）及高强度DLIR（DLIR-H）算法进行重建，共获得6组MAR和非MAR图像，并于工作站生成40～140 keV（间隔20 keV）单能级图像VMIASIR-V50%、VMIDLIR-M及VMIDLIR-H。比较各组图像主、客观图像质量评价结果，筛选最佳能级及最佳算法；以数字减影血管造影（DSA）所见为参考，观察基于不同图像检出并发症效能，以及所测动脉瘤颈长度和双侧载瘤动脉直径与DSA测值的差值。结果 80 keV及VMIDLIR-H的整体主、客观评分均最佳（P均＜0.05）。MAR图像均显示2例动脉瘤残留、4例动脉瘤破裂或出血、10例载瘤动脉狭窄或闭塞且均与DSA相符，而非MAR图像均未检出并发症。相比非MAR，基于MAR图像所测动脉瘤颈长度及双侧载瘤动脉直径均与DSA测值的差值更小（P均＜0.05）。结论 VMIDLIR、尤其80keV VMIDLIR-H联合MAR能显著改善ICA经弹簧圈栓塞后CTA图像质量。 |
| 英文摘要: |
| Objective To observe the value of virtual monoenergetic imaging （VMI） based on deep learning image reconstruction （DLIR） algorithm （VMIDLIR） combined with metal artifact reduction （MAR） technology for improving image quality of CT angiography （CTA） of intracranial aneurysm （ICA） after coil embolization. Methods Totally 44 patients with ICA who would receive metal coil embolization were prospectively enrolled. After CTA， MAR and non-MAR images were reconstructed with adaptive statistical iterative reconstruction-Veo 50% （ASIR-V50%）， medium DLIR （DLIR-M） and high DLIR （DLIR-H） algorithms， respectively， and 6 sets of images were obtained. VMIASIR-V50%， VMIDLIR-M and VMIDLIR-H images at 40—140 keV （with an interval of 20 keV） were generated at the workstation. The subjective and objective scores of image quality were compared to screen the best energy level and algorithm. Taken digital subtraction angiography （DSA） findings as the references， the efficacy of different images for detecting complications， as well as the difference between the measured aneurysm neck length and bilateral artery diameter with DSA were observed. Results The overall subjective and objective scores of 80 keV images and VMIDLIR-H images were both the best （all P＜0.05）. Two cases of residual aneurysm， 4 cases of ruptured or bleeding aneurysm and 10 cases of stenosis or occlusion of the parent artery were detected according to MAR images and were consistent with DSA findings， while no complication was found based on non-MAR images. Compared with non-MAR images， the differences of aneurysm neck length and bilateral parent artery diameter measured in MAR images and DSA were smaller （all P＜0.05）. Conclusion VMIDLIR， especially 80 keV VMIDLIR-H combined with MAR could significantly improve image quality of CTA for ICA after coil embolization. |
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