Improved imaging quality and diagnostic performance of low dose CT scan of lumbar intervertebral disc by combined with IMR reconstruction

doi:10.16150/j.1671-2870.2019.03.019

Abstract

Abstract:

Objective: To study the CT imaging quality of low dose scanning lumbar intervertebral disc combined with IMR reconstruction and its consistency with MRI diagnosis. Methods: Forty patients suspected of lumbar intervertebral disc diseases were enrolled in the study. All patients underwent lumbar plain CT and MRI examination. Patients were divided into two groups: low-dose group (100 kV and DoseRight index 15) and conventional dose group（100 kV and Dose Right index of 26）. Images were reconstructed along the direction of the intervertebral space with 1 mm thickness. Images in the low-dose group were reconstructed by filtering back-projection (FBP) and IMR (level 1, soft tissue algorithm), while those in the conventional dose group were reconstructed by FBP algorithm. Parameters of each intervertebral disc were measured, including the CT value of intervertebral disc, yellow ligament, vertebral canal, lumbar major or iliopsoas muscle, and subcutaneous fat noise in the back. SNR (signal to noise ratio) and CNR (contrast to noise ratio) were calculated, respectively. Imaging quality was evaluated by 5-scale points. MRI was defined as the reference standard to evaluate the diag-nostic accuracy. Results: Radiation dose indices in the low dose group were significantly lower than those in the conventional dose group [CTDI_vol: （5.49±1.48） mGy vs（1.06±4.42） mGy; DLP: （182.36±51.10） mGy·cm vs （730.05±182.45） mGy·cm; Effective dose: （2.35±0.66） mSv vs （9.42±2.35） mSv, P<0.05]. The SNR and CNR of IMR images of the low-dose IMR group were superior to those of FBP images of low-dose and conventional-dose group(P<0.05). The diagnostic accuracy of low-dose IMR images (95%) was significantly higher than that of FBP images in low-dose group(45%) and was similar to that of FBP images of conventional-dose group (90%). Conclusions: Low-dose CT scan of intervertebral disc combined with IMR reconstruction algorithm can improve imaging quality and diagnostic performance.

Key words: Iterative model reconstruction, Low dose, Intervertebral disc, Imaging quality, Diagnosis

CLC Number:

R445

FANG Shu, DU Lianjun, QIN Le, DONG Haipeng, YAN Fuhua, WANG Tao. Improved imaging quality and diagnostic performance of low dose CT scan of lumbar intervertebral disc by combined with IMR reconstruction[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(03): 344-348.

Figures/Tables 5

References 12

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项目	低剂量组（n=20）	常规剂量对照组（n=20）	P值
性别（男/女）	14/6	12/8	0.507
年龄（岁）	60.09±19.29	56.92±19.26	0.692
体质量指数	23.11±2.62	25.02±3.57	0.156
管电流（mAs）	135.18±35.89	518.62±108.95	<0.001
CTDI_vol（mGy）	5.49±1.48	21.06±4.42	<0.001
DLP（mGy·cm）	182.36±51.10	730.05±182.45	<0.001
ED（mSv）	2.35±0.66	9.42±2.35	<0.001

项目	常规剂量组FBP 图像（n=80）	低剂量组FBP 图像（n=80）	低剂量组IMR 图像（n=80）	P值	a 比b	a比c	b比c
椎间盘SNR	6.76±2.04	3.04±1.12	11.52±4.74	<0.001	<0.001	0.001	<0.001
黄韧带SNR	7.54±2.26	3.02±1.50	10.85±5.79	<0.001	<0.001	0.248	<0.001
椎管SNR	1.27±0.86	0.70±0.64	2.24±2.09	<0.001	0.003	0.176	<0.001
椎体髓腔SNR	13.26±7.91	5.95±3.17	21.52±11.82	<0.001	<0.001	0.011	<0.001
椎间盘CNR	2.24±1.21	0.96±0.66	3.81±2.36	<0.001	<0.001	0.023	0.001
黄韧带CNR	3.00±1.61	1.01±0.88	3.74±3.33	<0.001	<0.001	1	<0.001
椎管CNR	3.30±1.50	1.59±0.93	6.04±3.16	<0.001	<0.001	0.001	<0.001
椎体髓腔CNR	8.83±7.44	4.24±2.37	15.56±9.25	<0.001	0.006	0.001	<0.001

评分	常规剂量组FBP 图像（n=80）	低剂量组FBP 图像（n=80）	低剂量组IMR 图像（n=80）	P值	a比 b	a比 c	b比c
软组织评分	4.19±0.63	2.79±0.56	4.42±0.59	<0.001	<0.001	0.581	<0.001
骨骼评分	4.52±0.50	4.09±0.37	3.58±0.54	<0.001	0.001	<0.001	0.001

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