| Objective Using gemstone CT equipment for heart spectrum scanning in-depth study on adaptive statistical iterative reconstruction(ASIR)technology platform,establish coronary artery image evaluation technology,standard optimization analysis and diagnosis method?Through the comparative analysis of spectral CT monochromatic imaging,mixed energy imaging and coronary angiography evaluation of coronary artery in patients after PCI,verifying the accuracy of application of monochromatic energy imaging in the evaluation of coronary artery after PCI,to provide new diagnostic methods in patients with follow-up after PCI.Methods From November 2015 to June 2016 in our hospital search for gem CT spectrum scanning of 38 cases of coronary stenting patients(97 stents)continuously,using the postprocessing tools of recombinant 80-140 keV(10keV /group)and ASIR(20%,50%,80%)of the 21 groups of monochromatic energy images and 140 kVp mixed energy images according to the image quality of coronary artery stent scores,By three radiodiagnosis physicians who have above deputy senior ranks to evaluate the images,select the highest score to be the best monochromatic energy images.According to the diameter of 2.0-3.0mm,3.0-3.5mm,3.5-4.0mm,the 97 stents were divided into three groups A,B,C.Measure the stent lumen diameter of A,B,C three groups in the best monochromatic energy images and 140 kVp mixed energy images.Analysis statistical data,and compare two models of the stent lumen display rate.Divided the result of coronary angiography of 84 stents in 31 follow-up patients into no stenosis,mild,moderate and severe stenosis four groups,reconstruct the best monochromatic energy images and 140 kVp mixed energy images,evaluat stent lumen stenosis,compare two models to determine the accuracy of the degree of lumen stenosis.Results In the 50% ASIR and 120 keV monochromatic energy images which get the highest scores,the average diameters of A,B,C three groups were measured as 1.57 mm,2.04 mm,2.59 mm respectively,In the mixed energy images,the average diameters of three groups were measured as 1.30 mm,1.64 mm,2.05 mm.The best monochromatic energy images can respectively show the inner diameters increased by 20.76%,24.39%,26.34% than 140 kVp mixed energy images in three sets of stents.Corresponding to the three sets of stents,there were statistically significant differences between the mean diameter of two modes measured(P<0.05).Compared with coronary angiography,the evaluation accuracy rate of the best monochromatic energy images of stent stenosis degree was 89.28%,140 kVp mixed energy images on the degree of stent stenosis evaluation accuracy rate was 82.14%.With ?2 test,analyze the diagnosis of 140 kVp mixed energy images and the diagnosis of 120 keV ASIR 50% images,CAG results respectively,the analysis results the differences were statistically significant(P <0.05);the analysis results of 120 keV ASIR 50% images diagnosis and CAG results show no significant difference(P >0.05).Comparison of each method has good consistency(Kappa > 0.75).Conclusion ASIR 50% and 120 keV monochromatic energy images is the best monochromatic energy images,.Compared with the 140 kVp energy images,it removes metal artifacts more powerful,and the display of the stent lumen is closer to the inner diameter of the stent,the error is smaller,and the stent structure can be well displayed;the application of the best monochromatic energy images for 3D reconstruction of coronary artery in coronary artery,can improve the quality of coronary artery imaging,and in stent restenosis evaluation,which is more accurate than mixed energy images and also has a good agreement with coronary angiography results.It can provide a new method which is safe,noninvasive and higher accuracy for the evaluation of coronary artery in patients after PCI. |
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