Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Coronary CT Angiography with Knowledge-Based Iterative Model Reconstruction for Assessing Coronary Arteries and Non-Calcified Predominant Plaques

  • Tao Li (Department of Radiology, Chinese People's Liberation Army General Hospital) ;
  • Tian Tang (Department of Radiology, Chinese People's Liberation Army General Hospital) ;
  • Li Yang (Department of Radiology, Chinese People's Liberation Army General Hospital) ;
  • Xinghua Zhang (Department of Radiology, Chinese People's Liberation Army General Hospital) ;
  • Xueping Li (Department of Radiology, Chinese People's Liberation Army General Hospital) ;
  • Chuncai Luo (Department of Radiology, Chinese People's Liberation Army General Hospital)
  • Received : 2018.07.07
  • Accepted : 2019.01.21
  • Published : 2019.05.01
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Abstract

Objective: To assess the effects of iterative model reconstruction (IMR) on image quality for demonstrating non-calcific high-risk plaque characteristics of coronary arteries. Materials and Methods: This study included 66 patients (53 men and 13 women; aged 39-76 years; mean age, 55 ± 13 years) having single-vessel disease with predominantly non-calcified plaques evaluated using prospective electrocardiogram-gated 256-slice CT angiography. Paired image sets were created using two types of reconstruction: hybrid iterative reconstruction (HIR) and IMR. Plaque characteristics were compared using the two algorithms. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the images and the CNR between the plaque and adjacent adipose tissue were also compared between the two reformatted methods. Results: Seventy-seven predominantly non-calcified plaques were detected. Forty plaques showed napkin-ring sign with the IMR reformatted method, while nineteen plaques demonstrated napkin-ring sign with HIR. There was no statistically significant difference in the presentation of positive remodeling, low attenuation plaque, and spotty calcification between the HIR and IMR reconstructed methods (all p > 0.5); however, there was a statistically significant difference in the ability to discern the napkin-ring sign between the two algorithms (χ2 = 12.12, p < 0.001). The image noise of IMR was lower than that of HIR (10 ± 2 HU versus 12 ± 2 HU; p < 0.01), and the SNR and CNR of the images and the CNR between plaques and surrounding adipose tissues on IMR were better than those on HIR (p < 0.01). Conclusion: IMR can significantly improve image quality compared with HIR for the demonstration of coronary artery and atherosclerotic plaques using a 256-slice CT.

Keywords

Acknowledgement

This study was supported by state key and research and development project grant 2016YFC1300300 and NSFC grant 81371547.

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