Purpose To investigate the effect of low tube voltage combined with adaptive iterative dose reduction using three-dimensional processing(AIDR 3D)on image quality,radiation dose and perforating arteries in head and neck CT angiography(CTA)in order to obtain the best scanning solution.Materials and Methods A total of 90 patients who underwent head and neck CTA examination in Shanghai Public Health Clinical Center from October 2020 to January 2022 were retrospectively divided into three groups according to different scanning conditions,with 30 cases in each group.The scanning parameters of group A were 120 kV and 300 mA,group B was 100 kV and automatic mA,and group C was 80 kV and automatic mA.AIDR 3D algorithm was used for data reconstruction in all three groups.Muscular and arterial CT intensification values,noise standard deviation(SD),signal-to-noise ratio(SNR),contrast noise ratio(CNR),CT dose index volume(CTDIvol),dose-length product(DLP),and radiation effective dose(ED)were measured.After post-processing,the obtained data were obtained to obtain multi-directional vascular images,and the image quality was subjectively scored,and the display of perforator vessels of superior thyroid artery was observed.The differences of image quality(subjective score of image quality,SNR,CNR,SD),radiation dose(CTDIvol,DLP,ED)and perforator artery display among the three groups were compared.Results The subjective score of C7 image quality was 4 in group B(93.3%),followed by group A(80.0%),and the lowest in group C(66.7%)(P<0.05).There was no significant difference in subjective score of C4 level image quality(P>0.05).In different vascular segments,the SNR[(33.46±3.46)Hu]and CNR[(29.18±3.14)Hu]in group B were slightly lower than those in group C[(38.58±3.65)Hu and(34.26±3.58)Hu].But it was higher than that in group A[(27.47±3.23)Hu,(22.17±3.12)Hu](P<0.05).CTDIvol[(4.16±1.14)mGy],DLP[(167.75±46.82)mGy·cm]and ED[(0.43±0.15)mSv]in group B were lower than those in group A[(8.51±2.13)mGy,(280.16±26.34)mGy·cm and(1.00±0.08)mSv].The DLP and ED of group A were significantly lower than those of group A,but only slightly higher than those of group C[(3.47±0.62)mGy,(139.06±25.37)mGy·cm and(0.34±0.08)mSv].In terms of superior thyroid artery perforators,the display ratio of group B was the highest(20 cases,66.7%),significantly higher than that of group A(15 cases,50.0%)and group C(10 cases,33.3%)(P<0.05).Conclusion When the head and neck CTA is scanned and data reconstruction is performed by AIDR 3D,best results are observed when the scan parameters are 100 kV,automatic milliamperes,with effectively controlling in the radiation dose,ensuring the image quality and the best displaying effect on perforating arteries,which is recommended for clinical use.
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