| 张飞飞,孙明华,杜欣,等.基于深度学习重建的超低管电压心脏CT用于小儿先天心脏病诊断[J].中华放射医学与防护杂志,2026,46(9):887-893.Zhang Feifei,Sun Minghua,Du Xin,et al.CardioBoost algorithm-based ultra-low tube voltage cardiac CT for pediatric congenital heart disease treatment[J].Chin J Radiol Med Prot,2026,46(9):887-893 |
| 基于深度学习重建的超低管电压心脏CT用于小儿先天心脏病诊断 |
| CardioBoost algorithm-based ultra-low tube voltage cardiac CT for pediatric congenital heart disease treatment |
| 投稿时间：2026-03-18 |
| DOI：10.3760/cma.j.cn112271-20260318-00105 |
| 中文关键词: 深度学习 先天性心脏病 儿童 辐射剂量 X射线计算机体层成像 |
| 英文关键词:Deep learning Congenital heart disease (CHD) Child Radiation dose Tomography X-ray tomography |
| 基金项目:先进医用材料与医疗器械全国重点实验室项目（YGSKL-SHTech-2025-KF01）；河南省科技研发计划联合基金重点项目（235200810029）；河南省医学科技攻关计划（LHGJ20250517） |
| 作者 | 单位 | E-mail | | 张飞飞 | 阜外华中心血管病医院放射科, 河南省心脏病影像医学重点实验室, 郑州 451460 | | | 孙明华 | 阜外华中心血管病医院放射科, 河南省心脏病影像医学重点实验室, 郑州 451460 | | | 杜欣 | 阜外华中心血管病医院放射科, 河南省心脏病影像医学重点实验室, 郑州 451460 | | | 苏涛 | 阜外华中心血管病医院放射科, 河南省心脏病影像医学重点实验室, 郑州 451460 | | | 彭俪颖 | 上海联影医疗科技股份有限公司联合创新部, 上海 201800 | | | 葛英辉 | 阜外华中心血管病医院放射科, 河南省心脏病影像医学重点实验室, 郑州 451460 | cjr.geyinghui@vip.163.com |
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| 中文摘要: |
| 目的 探讨60 kVp超低管电压CT扫描联合心脏专用深度学习重建（CardioBoost）在降低小儿先天性心脏病（CHD）辐射剂量、改善诊断效能中的价值。方法 前瞻性纳入272例3岁以下CHD患儿，其中139例行常规剂量扫描（A组，80 kVp、100 mAs），133例行低剂量扫描（B组，60 kVp、60 mAs）。记录有效剂量E。对A、B组原始图像行混合迭代重建（HIR）获得A1及B1组图像，行CardioBoost获得A2及B2组图像。比较4组图像目标结构的信噪比（SNR）、对比噪声比（CNR）。采用5分制评价心内结构、心外大血管、冠状动脉近段、整体图像质量及诊断信心评分。诊断效用评价包括：是否回答了主要诊断问题；诊断结果与手术符合率；是否新增诊断信息。结果 与A组相比，B组E为0.14（0.13，0.20）mSv，降低了81.33%。B2组的SNR、CNR均优于A1、B1组（Z = -14.90 ~ -8.11，P<0.05），与A2组相当或更优。B2组各项主观评分均显著优于B1组（Z = -11.81 ~ -9.79，P<0.05），与A1组相当（P>0.05）；三组均劣于A2组。在回答主要诊断问题方面，B2组优于B1组，但差异无统计学意义（P>0.05）；B2组与A1、A2组的差异亦无统计学意义（P>0.05）。B2组的诊断符合率高于B1组（χ2 = 20.13，P<0.05），与A1、A2组的差异无统计学意义（P>0.05）。A、B组中分别有78.42%和74.44%的病例补充了额外诊断信息。结论 基于CardioBoost的超低剂量心脏CT可在辐射剂量降低81%的条件下维持良好的图像质量，显著提升了诊断信心与诊断效能，为小儿CHD的CT诊断提供了更优方案。 |
| 英文摘要: |
| Objective To explore the clinical value of 60 kVp ultra-low tube voltage CT combined with CardioBoost-a cardiac-specific deep-learning reconstruction algorithm-in reducing radiation doses and improving diagnostic efficacy for treatment of pediatric congenital heart disease (CHD).Methods This prospective study enrolled 272 child patients with CHD under 3 years old. Among these, 139 cases underwent conventional-dose cardiac computed tomography angiography (CTA) scans (group A: 80 kVp, 100 mAs), while the remaining 133 cases received low-dose CTA scans (group B: 60 kVp, 60 mAs). The effective doses (E) to these patients were recorded. The raw data of groups A and B were processed using hybrid iterative reconstruction (HIR), yielding image groups A1 and B1, and were handled using CardioBoost, yielding image groups A2 and B2. For these four image groups, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of target structures were compared, and the 5-point scale was adopted to score their intracardiac structures, extracardiac great vessels, proximal segments of coronary arteries, overall image quality, and diagnostic confidence. The elevation of diagnostic efficacy involved responses to primary diagnostic questions, the coincidence rate between the diagnosis and surgical result, and the addition of new diagnostic information.Results Compared to group A, group B exhibited a lower E value of 0.14 (0.13, 0.20) mSv, representing an 81.33% decrease. The SNR and CNR of subgroup B2 were better than those of subgroups A1 and B1 (Z = -14.91 to -8.11, P < 0.05) and were comparable to or better than those of subgroup A2. The scores of all subjective evaluations of subgroup B2 were significantly better than those of subgroup B1 (Z = -11.81 to -9.79, P < 0.05) and comparable to those of subgroup A1 (P > 0.05); however, these three subgroups were all inferior to subgroup A2 in the scores. Regarding responses to the primary diagnostic questions, subgroup B2 outperformed subgroup B1, with no statistically significant differences(P>0.05), while there was no statistically significant differences between subgroup B2 and subgroup A1 or A2 (P > 0.05). Concerning the diagnostic coincidence rate, subgroup B2 outperformed subgroup B1 (χ2= 20.13, P < 0.05), while no statistically significant differences were observed between subgroup B2 and subgroup A1 or A2 (P > 0.05). Additional diagnostic information was provided for 78.42% and 74.44% of cases in subgroups A and B, respectively.Conclusions The CardioBoost-based ultra-low-dose cardiac CT can maintain high image quality while reducing radiation doses by 81%, significantly improving diagnostic confidence and efficacy and providing optimal protocols for CT diagnosis of pediatric CHD. |
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