目的 探讨 320 排CT螺旋扫描模式下应用单能量去金属伪影技术(single energy metal artifact reduction,SEMAR)在复杂腹主动脉瘤腔内修复术(endovascular aortic repair,EVAR)联合弹簧圈瘤体栓塞术后CTA复查中的应用价值.方法 回顾性分析 2023 年 8 月至 2024 年 2 月在复旦大学附属中山医院行EVAR联合弹簧圈瘤体栓塞术后30d行腹部CTA复查的 14 例腹主动脉瘤患者和 2 例髂内动脉瘤患者的CTA图像.对原始数据分别用混合迭代重建算法(non-SEMAR组)和联合SEMAR算法(SEMAR组)进行重建,对比两组图像伪影指数(artifact index,AI)、伪影周围对比噪声比(contrast-to-noise ratio,CNR)和主观评分.结果 SEMAR组弹簧圈上、下、左、右和邻近主动脉腔内的AI值均低于non-SEMAR组(38.16±19.20 vs 89.29±30.93、30.75±16.28 vs 82.62±28.01、33.61±16.18 vs 74.90±26.28、44.99±15.91 vs 87.72±33.70 和 24.49±12.58 vs 47.29±13.55,P＜0.001);SEMAR组各方位CNR高于non-SEMAR组(2.47±2.15 vs 1.01±0.74、2.32±2.01 vs 0.72±0.50、4.93±4.15 vs 1.38±0.79、4.10±4.14 vs 1.56±1.18 和 19.91±11.01 vs 11.01±7.77,P＜0.05).与non-SEMAR组相比,SEMAR组图像主观评分明显增加(P＜0.001).结论 SEMAR技术可减少弹簧圈伪影,提高瘤体、内脏动脉、支架和内漏显示的清晰度,对EVAR术后随访有重要临床意义.
Application value of single energy metal artifact reduction in the follow-up CT angiography after endovascular repair of abdominal aortic aneurysm combined with coil embolization
Objective To explore the application value of single energy metal artifact reduction technology(SEMAR)in the CTA follow-up of complex abdominal aortic aneurysm endovascular repair(EVAR)combined with coil embolization using 320-slice CT spiral scanning mode.Methods A retrospective analysis was conducted on the images of 14 patients with abdominal aortic aneurysm and 2 patients with internal iliac artery aneurysm who underwent abdominal CTA reexamination 30 days after EVAR combined with coil embolization at Zhongshan Hospital,Fudan University from August 2023 to February 2024.The original data were reconstructed using a hybrid iterative reconstruction algorithm(non-SEMAR group)and a combined reconstruction and SEMAR algorithm(SEMAR group),and the artifact index(AI),contrast-to-noise ratio(CNR),and subjective scores between the two groups were compared.Results The AI values of up,down,left,right around the spring coil and adjacent aortic cavity in the SEMAR group were lower than those in the non-SEMAR group(38.16±19.20 vs 89.29±30.93,30.75±16.28 vs 82.62±28.01,33.61±16.18 vs 74.90±26.28,44.99±15.91 vs 87.72±33.70,and 24.49±12.58 vs 47.29±13.55;P＜0.001),and the CNRs in the SEMAR group were higher than those in the non-SEMAR group(2.47±2.15 vs 1.01±0.74,2.32±2.01 vs 0.72±0.50,4.93±4.15 vs 1.38±0.79,4.10±4.14 vs 1.56±1.18,and 19.91±11.01 vs 11.01±7.77;P＜0.05).Compared with the non-SEMAR group,the subjective scores of image in the SEMAR group were higher(P＜0.001).Conclusions SEMAR technology can significantly reduce the artifact of spring coil,improve the clarity of tumors,visceral arteries,stents,and internal leaks images,and has important clinical significance for follow-up after EVAR surgery.
abdominal aortic aneurysminternal iliac artery aneurysmsingle energy metal artifact reduction technologyCT angiographyendovascular repair of abdominal aortic aneurysm
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