冠状动脉计算机断层扫描血管造影中尺寸特异性剂量估计与图像质量之间的关系取决于管电压和扫描视场

摘要(中文译文)

计算机断层扫描（CT）技术的进步推动了心脏应用的快速发展，实现图像质量和辐射剂量之间的平衡已成为当前的研究重点。本研究旨在定量评估冠状动脉CT血管造影（CCTA）中管电压和扫描视场（SFOV）选择对图像质量和辐射剂量的影响，并分析性别差异，从而促进为患者制定个性化的扫描方案。回顾性纳入在256排CT扫描仪上接受CCTA检查的120名患者，并根据管电压、SFOV和性别分为8个亚组。收集患者的轴向图像，并从剂量报告中提取体积CT剂量指数（CTDIvol）值。基于轴向CT图像或CT定位器放射线照片计算患者的轴向尺寸比剂量估计（SSDEz），并将感兴趣区域（ROI）放置在血管的目标切片上，以确定图像质量的客观评估。首先，我们分析了在不同管电压（120和100 kV）和SFOV（大SFOV和小SFOV）设置下，性别之间的辐射剂量度量（CTDIvol、SSDEz）差异。其次，我们探讨了这些参数设置对客观图像质量的影响。最后，我们使用线性回归拟合来评估辐射剂量指标与客观图像质量指标之间的相关性。在不同的管电压和SFOV设置下，女性患者的CTDIvol和SSDEz均高于男性患者。后者的差异具有统计学意义，P值分别为0.031和0.047。不同管电压组和SFOV组的SSDEz分别比CTDIvol高29%和49%。100 kV和小SFOV的参数选择通常显示出更好的图像质量，SSDEz与信噪比（SNR）和对比度噪声比（CNR）之间的相关性更强。由于组织结构的差异，女性患者在CCTA期间接受了更高的辐射剂量。CTDIvol低估了患者剂量，建议使用SSDEz评估。在确保不遗漏病变的前提下，建议使用100 kV和小SFOV的参数扫描，以获得更好的图像质量。

Abstract

Advances in computed tomography (CT) technology have driven rapid development in cardiac applications, and achieving a balance between image quality and radiation dose has become a current research focus. This study aimed to quantitatively evaluate the effects of tube voltage and scan field of view (SFOV) selection on image quality and radiation dose in coronary CT angiography (CCTA), and analyze gender differences, thereby facilitating the development of personalized scanning protocols for patients. A total of 120 patients who underwent CCTA examinations on a 256-row CT scanner were retrospectively included and divided into eight subgroups based on tube voltage, SFOV, and gender. Patients' axial images were collected, with volume CT dose index (CTDI) values extracted from dose reports. Axial size-specific dose estimation (SSDE) of the patients was calculated based on axial CT images or CT localizer radiographs, and the region of interest (ROI) was placed on the target sections of vessels to determine objective evaluation of image quality. First, we analyzed the differences in radiation dose metrics (CTDI, SSDE) between genders under varying tube voltages (120 and 100 kV) and SFOV (large SFOV and small SFOV) settings. Second, we explored the impact of these parameter settings on objective image quality. Finally, we used linear regression fitting to evaluate the correlation between radiation dose metrics and objective image quality indicators. Under different tube voltage and SFOV settings, both CTDI and SSDE were higher in female patients than in males. The difference in the latter metric was statistically significant, with P values of 0.031 and 0.047, respectively. SSDE in different tube voltage groups and SFOV groups were 29% and 49% higher than CTDI. A parameter choice of 100 kV and small SFOV generally showed better image quality, and the correlation between SSDE and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was stronger. Due to differences in tissue structure, female patients receive a higher radiation dose during CCTA. The CTDI underestimates the patient dose, and it is recommended to use the SSDE assessment. On the premise of ensuring no omission of lesions, it is advisable to use parameter scanning with 100 kV and small SFOV for superior image quality.

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