Abstract
The aim was to explore the application value of computed tomography (CT) perfusion (CTP) imaging based on the iterative model reconstruction (IMR) in the diagnosis of acute cerebral infarction (ACI). 80 patients with ACI, admitted to hospital, were selected as the research objects and divided randomly into a routine treatment group (group A) and a low-dose group (group B) (each group with 40 patients). Patients in group A were scanned at 80 kV–150 mAs, and the traditional filtered back projection (FBP) algorithm was employed to reconstruct the images; besides, 80 kV–30 mAs was adopted to scan the patients in group B, and the images were reconstructed by IMR1, IMR2, IMR3, iDose4 (a kind of hybrid iterative reconstruction technology), and FBP, respectively. The application values of different algorithms were evaluated by CTP based on the collected CTP images of patients and detecting indicators. The results showed that the gray and white matter CT value, SD value, SNR, CNR, and subjective image scores of patients in group B were basically consistent with those of group A (p > 0.05) after the IMR1 reconstruction, and the CT and SD of gray and white matter in patients from group B reduced steeply (p < 0.05), while SNR and CNR increased dramatically after IMR2 and IMR3 reconstruction in contrast to group A (p < 0.05). Furthermore, the cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) of contrast agent, and time to peak (TTP) of contrast agent in patients from group B after iDose4 and IMR reconstruction were basically the same as those of group A (p > 0.05). Therefore, IMR combined with low-dose CTP could obtain high-quality CTP images of the brain with stable perfusion indicators and low radiation dose, which could be clinically applied in the diagnosis of ACI.
Highlights
acute cerebral infarction (ACI) is a common disease and known as acute ischemic stroke
It was found that the images with high current were relatively clear (A-filtered back projection (FBP)), while the computed tomography (CT) images obtained by different reconstruction algorithms in group B were slightly different in quality. e reconstructed images of FBP, IMR1, IMR2, and IMR3 were relatively clear, but the reconstructed images of iDose4 were quite fuzzy, which was not good for observation
In contrast to group A, the obtained CT values of gray and white matter reconstructed by FBP and iDose4 increased dramatically in patients of group B (p < 0.05); there were no obvious differences in CT values of gray and white matter reconstructed by IMR1 in patients from group B (p > 0.05); the CT value of gray matter reconstructed by IMR2 reduced sharply (p < 0.05), but the value of CT in white matter was not considerably different (p > 0.05); and the values of CT in gray and white matter reconstructed by IMR3 reduced hugely both (p < 0.05)
Summary
ACI is a common disease and known as acute ischemic stroke. It is of great importance to determine the time window of reperfusion therapy for patients with ACI. CTP can determine the core of lesion and ischemic area of patients with ACI to make clinical diagnosis and determine the treatment plan in a relatively short time, so as to avoid the constraints of time window, reduce the mortality and disability rate of patients, and monitor patient’s prognosis [3]. CTP is irreplaceably featured with the diagnosis of patients with ACI, excessive radiation dose is its biggest shortcoming in the diagnosis. CTP requires continuous and repeated scanning of the target area of the brain, resulting in a huge increase in the X-ray radiation dose received by a patient by comparing with conventional CT
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