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CT大重建矩阵联合重建算法对肺结节的诊断价值

CT Large Reconstruction Matrix Combined with Reconstruction Algorithm in the Diagnosis of Pulmonary Nodules

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目的 探讨CT大重建矩阵1024×1024联合Karl迭代重建算法对肺结节的诊断价值.资料与方法 前瞻性收集2021年10 月—2022年5 月于大连医科大学附属第一医院行胸部CT检查的 500 例患者,对CT扫描图像原始数据进行分组重建.A组采用常规512×512矩阵结合Karl 5级重建;B组采用1 024×1 024大重建矩阵结合不同等级Karl算法重建,获得B1(Karl 6)、B2(Karl 7)、B3(Karl 8)、B4(Karl 9)4个亚组.测量主动脉弓上方的气管腔内(气管区)及左肺上叶无血管区(肺实质)的CT值和噪声值,计算信噪比.由2 位医师评价A、B组肺部总体图像质量.比较B组中图像质量最佳亚组与A组病灶显示情况,依据手术病理结果,分析诊断效能.结果 B组组内随Karl等级升高,气管和肺实质标准差值逐渐下降,信噪比逐渐升高(F=675.002~2 020.903,P<0.05).B组各项主观评分均高于A组(Z=-15.361~-6.465,P<0.05),B4 组主观评分最高.A组和B4组部分实性结节(≤3 mm)和实性结节(6.1 mm~≤3 cm)显示清晰度差异无统计学意义(Z=-2.000、-0.378,P>0.05);与A组相比,B4组结节显示清晰率提升12%~100%;胸膜凹陷征显示差异无统计学意义(χ2=2.143,P>0.05).以43例手术病理结果为诊断金标准,B4组诊断准确度为65.12%,优于A组的41.86%(χ2=4.674,P<0.05).结论 大重建矩阵联合Karl算法可以获得较好的图像质量,有利于诊断肺结节.
Purpose To explore the value of CT large reconstruction matrix 1024×1024 combined with iterative reconstruction algorithm Karl in the diagnosis of pulmonary nodules.Materials and Methods A total of 500 patients who underwent chest CT examination at the First Affiliated Hospital of Dalian Medical University from October 2021 to May 2022 were prospectively collected,and the raw data of CT scans were reconstructed to divide into group A and B.Group A was reconstructed using a conventional 512×512 matrix combined with Karl 5 reconstruction;group B was reconstructed using a large 1 024×1 024 reconstruction matrix combined with different levels of Karl algorithm to obtain four subgroups,including B1(Karl 6),B2(Karl 7),B3(Karl 8)and B4(Karl 9)subgroup.The signal-to-noise ratio was calculated by measuring the CT and standard deviation values of the tracheal lumen above the arch of the aorta(tracheal area)and the avascular area of the upper lobe of the left lung(lung parenchyma).The overall image quality of the lungs in group A and B was evaluated by two physicians.The best image quality subgroup in group B was compared with the lesion display in group A.The diagnostic efficacy was analyzed based on the surgical pathology results.Results In group B,the standard deviation values of trachea and lung parenchyma gradually decreased and the signal-to-noise ratio gradually increased as the Karl grade increased compared with group A(F=675.002-2 020.903,all P<0.05).All subjective scores in group B were significantly higher than those in group A(Z=-15.361--6.465,all P<0.05),and the highest subjective scores were found in group B4.Some solid nodules(≤3 mm)and solid nodules(6.1 mm-≤3 cm)showed no statistically significant difference in clarity(Z=-2.000,-0.378,both P>0.05).Compared with group A,group B4 showed a 12%-100%improvement in nodule clarity.Only pleural depression sign showed the difference was not statistically significant(χ2=2.143,P>0.05).Taking 43 cases of surgical pathology as the gold standard,the diagnostic accuracy of group B4 was 65.12%,which was better than that of group A,which was 41.86%(χ2=4.674,P<0.05).Conclusion The combined application of the large reconstruction matrix and the Karl iteration algorithm results in superior image quality and facilitates the diagnosis of lung nodules.

Pulmonary nodulesTomography,X-ray computedReconstruction matrixIterative reconstruction algorithmImage qualitySignal-to-noise ratioNoise

王旭、李贝贝、童小雨、陈安良、周宇婧、刘义军

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大连医科大学附属第一医院放射科,辽宁 大连 116011

肺结节 体层摄影术,X线计算机 重建矩阵 迭代重建算法 图像质量 信噪比 噪声

2024

中国医学影像学杂志
中国医学影像技术研究会

中国医学影像学杂志

CSTPCD北大核心
影响因子:1.37
ISSN:1005-5185
年,卷(期):2024.32(10)