The application single energy imaging of energy spectrum computed tomography and metal artifact reduction algorithm in the angiography of patients with liver cirrhotic portal hypertension after transjugular intrahepatic portosystemic stent shunt treatment

Abstract

Abstract: Objective To explore the application value of single energy imaging of energy spectrum computed tomography (CT) and metal artifact reduction algorithm (MAR) in the angiography of patients with liver cirrhotic portal hypertension after transjugular intrahepatic portoystemic stent shunt (TIPSS) treatment.Methods A total of 127 patients with liver cirrhotic portal hypertension who were admitted to affiliated hospital of Nantong University from May 2018 to May 2019 were selected. All the patients received TIPSS after admission and underwent single-energy imaging of energy spectrum CT examination at one month after the treatment. The images were processed by MAR method. The artifact index (AI) of 60keV, 120keV, 120kV-like, 60keV+120keV, 120kV-like +keV images were calculated, and the images were then reviewed by two experienced radiologists. The anatomical structure clarity, artifact suppression, and overall image quality of the images were evaluated by 5 grade scoring method, and the differences in image quality scores of different images were compared. Results The AI values of the images of 0keV, 120keV, 120kV-like, 60keV+120keV and 120kV-like +keV were (33.51±6.87), (17.42±2.90), (26.43±4.71), (24.12±3.44) and (21.50±3.13), respectively, and the differences were statistically significant (P<0.05).The anatomical clarity scores of 120keV and 60keV+120keV images were significantly higher than those of 60keV, 120kV-like and 120kV-like +keV images (P<0.05). Artifact inhibition and overall image quality scores of 60keV+120keV images were significantly higher than those of 60keV, 120keV, 120kV-like and 120kV-like +keV images, all with P<0.05.Conclusion In patients with portal hypertension due to cirrhosis, MAR image processing can eliminate postoperative artifacts when performing single-energy imaging of energy spectrum CT examination after TIPSS treatment, in which 60keV+120keV can eliminate image artifacts while clearly show the vascular condition.

Key words: Liver cirrhotic portal hypertension, Transjugular intrahepatic portosystemic stent shunt, Computed tomography, Metal artifact reduction algorithm, Image quality

SHAN Qin-xing, ZHANG Xiao-dong, WANG Xi. The application single energy imaging of energy spectrum computed tomography and metal artifact reduction algorithm in the angiography of patients with liver cirrhotic portal hypertension after transjugular intrahepatic portosystemic stent shunt treatment[J]. Chinese Hepatolgy, 2021, 26(5): 502-504.

References

[1] Mookerjee RP, Mehta G, Balasubramaniyan V, et al. Hepatic dimethylarginine-dimethylaminohydrolase1 is reduced in cirrhosis and is a target for therapy in portal hypertension. J Hepatol, 2015, 62:325-331.
[2] Marco VD, Calvaruso V, Ferraro D, et al. Effects of eradicating hepatitis c virus infection in patients with cirrhosis differ with stage of portal hypertension. Gastroenterology, 2016, 151:130-139.
[3] Li Z. Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis. J Hepatol, 2011, 54:78-88.
[4] Bissonnette J, Garcia-Pagán, Juan Carlos, Albillos, Agustín, et al. Role of the transjugular intrahepatic portosystemic shunt in the management of severe complications of portal hypertension in idiopathic noncirrhotic portal hypertension. Hepatology, 2016, 64:224-231.
[5] 李腾飞, 马骥, 袁慧锋,等. 高分辨C型臂CT联合去金属伪影技术在颅内动脉瘤LVIS支架辅助栓塞术中的应用. 中华神经外科杂志, 2019, 35:541-546.
[6] 李晓莉, 冯卫华, 董诚, 等. CT能谱成像技术减除金属植入物伪影的定量实验研究. 中华放射学杂志, 2011, 45:736-739.
[7] Ohgiya Y, Suyama J, Seino N, et al. MRI of the neck at 3 tesla using the periodically rotated overlapping parallel lines with enhanced reconstruction (propeller) (blade) sequence compared with t2-weighted fast spin-echo sequence. J Magn Reson Imaging, 2010, 32:1061-1067.
[8] Afdhal N, Everson GT, Calleja JL, et al. Effect of viral suppression on hepatic venous pressure gradient in hepatitis c with cirrhosis and portal hypertension. J Viral Hepat, 2017, 24:823-831.
[9] Knop V, Hoppe D, Welzel T, et al. Regression of fibrosis and portal hypertension in hcv゛ssociated cirrhosis and sustained virologic response after interferon-free antiviral therapy. J Viral Hepat, 2016, 23:994-1002.
[10] Hervé G, Grabar S, Vignaux O, et al. Portal hypertension in patients with cirrhosis: indirect assessment of hepatic venous pressure gradient by measuring azygos flow with 2d-cine phase-contrast magnetic resonance imaging. Eur Radiol, 2016, 26:1981-1990.
[11] Bayraktar Y, Oztürk MA, Egesel T, et al. Disappearance of "pseudocholangiocarcinoma sign" in a patient with portal hypertension due to complete thrombosis of left portal vein and main portal vein web after web dilatation and transjugular intrahepatic portosystemic shunt. J Clin Gastroenterol, 2000, 31:328-332.
[12] Palikhe M, Xue H, Jha RK, et al. Changes in portal hemodynamics after tips in liver cirrhosis and portal hypertension. Scand J Gastroenterol, 2013, 48:570-576.
[13] Zhang JS, Li L, Hou WY, et al. Spleen-preserving proximal splenic-left intrahepatic portal shunt for the treatment of extrahepatic portal hypertension in children. J Pediatr Surg, 2015, 50:1072-1075.
[14] Su L, Dong J, Sun Q, et al. Spectral ct Imaging in Patients with budd-chiari syndrome: investigation of image quality. Cell Biochem Biophys, 2014, 70:1043-1049.
[15] Park HS, Hwang D, Seo JK . Metal artifact reduction for polychromatic x-ray ct based on a beam-hardening corrector. IEEE Trans Med Imaging, 2016, 35:480-487.
[16] Lamichhane N, Padgett K, Li X, et al. SU-F-J-73: Simple approach for quantification of metal artifact reduction capabalities of dual-energy ct. Med Phys, 2016, 43:3423-3423.
[17] Mennecke A, Svergun S, Scholz B, et al. Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector ct in comparison to pre-treatment ct in patients with acute subarachnoid haemorrhage. Eur Radiol, 2017, 27:88-96.
[18] 惠萍, 王新江, 崔志鹏,等. CT能谱成像在消除金属移植物伪影中的应用价值. 中华放射学杂志, 2011, 45:740-742.
[19] 宁志光, 马国峰, 于远,等. 宽体探测器CT多物质伪影降低技术对CT扫描图像质量的影响. 中华放射学杂志, 2017, 51:790-793.
[20] 苏蕾, 梁盼, 吕培杰,等. 宽体探测器CT多物质伪影降低技术在经颈静脉肝内门体分流术及栓塞术后门静脉血管成像中的应用价值. 中华医学杂志, 2019, 99:44-48.