实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (12): 1213-1216.doi: 10.3969/j.issn.1003-9198.2025.12.005

• 专题研究 • 上一篇    下一篇

光子计数CT与能量积分探测器CT用于冠状动脉支架成像的图像质量对比

徐智颖, 秦乐, 艾斯凯尔江·亚力坤, 董海鹏, 严福华, 朱思奇   

  1. 200025 上海市,上海交通大学医学院附属瑞金医院放射科(徐智颖,秦乐,董海鹏,严福华,朱思奇);
    844000 新疆维吾尔自治区喀什市,新疆喀什地区第二人民医院放射科(艾斯凯尔江·亚力坤)
  • 收稿日期:2025-09-12 发布日期:2025-12-26
  • 通讯作者: 朱思奇,Email: zsq40916@rjh.com.cn
  • 基金资助:
    上海市公共卫生体系建设三年行动计划优青计划(GWV-10.2-YQ30)

Coronary artery stent imaging based on photon-counting CT: comparison with energy-integrating detector CT

XU Zhiying, QIN Le, Aisikaierjiang Yalikun, DONG Haipeng, YAN Fuhua, ZHU Siqi   

  1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China (XU Zhiying, QIN Le, DONG Haipeng, YAN Fuhua, ZHU Siqi);
    Department of Radiology, Kashi Prefecture Second People’s Hospital, Kashi 844000, China (Aisikaierjiang Yalikun)
  • Received:2025-09-12 Published:2025-12-26
  • Contact: ZHU Siqi, Email: zsq40916@rjh.com.cn

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摘要： 目的 探讨在冠状动脉支架CT成像中,光子计数CT(PCCT)的超高分辨率(UHR)模式,相较于能量积分探测器CT(EID-CT)常规成像模式的优势。 方法 前瞻性分析15例冠状动脉支架植入术后患者(32根支架)的影像资料。所有患者以UHR模式进行PCCT的冠状动脉CT造影(CCTA),且PCCT检查前均进行过EID-CT的CCTA检查。客观评价指标包括支架内管腔直径、支架外直径、晕状伪影指数、支架内外血管CT值差和支架内管腔噪声。主观评价指标包括支架内管腔、支架结构、支架外钙化斑块、支架周围血管显示情况,支架内再狭窄诊断信心、射束硬化伪影和晕状伪影,以李克特5分法进行评估。 结果 PCCT图像的支架内直径和支架内管腔噪声显著高于EID-CT图像(P<0.001),晕状伪影指数和支架内外血管CT值差显著低于EID-CT图像(P<0.001);2组图像的支架外直径差异无统计学意义(P=0.366)。PCCT在所有主观评价指标上的得分均显著高于EID-CT(P<0.001)。 结论 PCCT在冠脉支架成像中能够获得比传统EID-CT更好的图像质量和诊断信心,未来有可能成为临床无创性评估冠状动脉支架通畅性的新方法。

关键词: 光子计数CT, 能量积分探测器CT, 冠状动脉支架, 图像质量

Abstract: Objective To explore the advantages of ultra-high resolution (UHR) mode of photon-counting detector CT (PCCT) over conventional imaging mode of energy-integrating detector CT (EID-CT) in coronary stent CT imaging. Methods The imaging data of 15 patients (32 stents) received coronary stent implantation were prospectively analyzed. All patients underwent coronary CT angiography (CCTA) with PCCT in UHR mode, and had a prior CCTA examination performed with EID-CT. Objective evaluation parameters included the diameter of the inner lumen of the stent, the outer diameter of the stent, the blooming artifact index, the difference in CT values inside versus outside the stent, and the noise within the stent lumen. Subjective evaluation was conducted using Likert’s 5-point method, including the display of the lumen in the stent, delineation of stent structure, visualization of calcified plaques outside the stent,display of peri-stent blood vessels, diagnostic confidence of in-stent restenosist,beam hardening artifacts and blooming artifacts. Results The internal diameter of the stent and the internal lumen noise of the stent measued by PCCT were significantly higher than those measured by EID-CT(P<0.001), while the blooming artifact index and the differences in the internal and external stent CT values of the stent measured by PCCT were significantly lower than those measured by EID-CT (P<0.001). There was no significant difference in the outer diameter of the stents beween the two groups of images (P=0.366). The PCCT images showed significantly higher scores for all subjective indexes than those of the EID-CT images (P<0.001). Conclusions PCCT can obtain better image quality and diagnostic confidence than traditional EID-CT in coronary stent imaging, and it may become a new method for clinical non-invasive evaluation of coronary stent patency in the future.

Key words: photon-counting CT, energy-integrating detector CT, coronary stent, image quality

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