ISSN 1004-4140
    CN 11-3017/P

    AIMAC在髋关节置换术后盆腔CT金属伪影校正中的应用价值

    Clinical Value of an Artificial-Intelligence–based Metal Artifact Correction Algorithm on Pelvic Computed Tomography After Hip Arthroplasty

    • 摘要: 目的:探讨深度学习金属伪影校正(AIMAC)在髋关节置换术后盆腔CT中的金属伪影抑制效果。方法:回顾性纳入2022年9月至2024年12月在我院接受盆腔CT检查且具有髋关节置换史的患者34例,分别采用常规重建(Karl 3D 5级)、传统MAC及AIMAC进行重建。主观评价由2名医师采用5分法对图像整体质量进行盲法评分,行Kappa一致性检验。客观评价勾画ROI并计算伪影层面与参考层面的CT值差异(ΔCT肌肉、ΔCT脂肪)、噪声(SD伪影、SD参考)、金属伪影指数(MAI)及CNR。3组总体比较根据数据正态性采用RM-ANOVA或Friedman检验;两两比较采用配对样本t检验或Wilcoxon符号秩检验,并以Holm–Bonferroni法校正P值(P*)。结果:两名医师对3组图像整体质量评分一致性良好(Kappa:0.866、0.816、0.794)。主观评分总体差异有统计学意义,AIMAC高于MAC高于常规重建(两两比较均有P* < 0.0001)。客观指标方面,ΔCT肌肉、ΔCT脂肪、SD伪影、MAI及CNR在3组间差异均有统计学意义,AIMAC优于MAC优于常规重建;SD参考方面,MAC低于常规重建与AIMAC,常规重建与AIMAC差异无统计学意义。结论:在髋关节置换术后盆腔CT中,AIMAC可较常规重建与MAC更有效抑制金属伪影、改善CT值稳定性并提高图像整体质量。

       

      Abstract: Objective: To investigate the performance of an artificial-intelligence–based metal artifact correction algorithm (AIMAC) on pelvic computed tomography (CT) after total hip arthroplasty. Methods: This retrospective study included data from 34 patients with a history of hip arthroplasty who underwent pelvic CT at our institution between September 2022 and December 2024. Raw data were reconstructed using three methods: routine reconstruction (Karl 3D, level 5), conventional metal artifact correction (MAC), and the AIMAC For subjective evaluation, two radiologists independently scored overall image quality using a five-point scale in a blinded manner, and inter-reader agreement was assessed using the kappa statistic. For objective evaluation, regions of interest were drawn to calculate CT-number differences between the artifact-affected and reference slices (ΔCTmuscle and ΔCTfat), image noise (standard deviation SDartifact and SDreference), the metal artifact index (MAI), and the contrast-to-noise ratio (CNR). Overall comparisons among the three reconstructions were performed using repeated-measures analysis of variance or the Friedman test, according to normality. Pairwise comparisons were conducted using the paired t-test or the Wilcoxon signed-rank test, with Holm–Bonferroni adjustment for multiple comparisons (P*). Results: Inter-reader agreement for overall image quality was good (kappa: 0.866, 0.816, and 0.794). Overall subjective scores differed significantly among the three methods, with the AIMAC scoring higher than MAC, and MAC scored higher than routine reconstruction (all pairwise P* < 0.0001). For objective metrics, the ΔCTmuscle, ΔCTfat, SDartifact, MAI, and CNR all had significant differences among the three methods, with the AIMAC outperforming MAC and routine reconstruction. For SDreference, MAC was lower than routine reconstruction and AIMAC, whereas no significant difference was observed between routine reconstruction and AIMAC. Conclusion: For pelvic CT after hip arthroplasty, the AIMAC more effectively reduced metal artifacts, improved CT-number stability, and enhanced overall image quality compared with routine reconstruction and conventional MAC.

       

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