诊断学理论与实践2025，Vol.24Issue(2)：125-134,10.DOI:10.16150/j.1671-2870.2025.02.003
光子计数CT在心血管疾病中的应用
Application of photon-counting CT in cardiovascular diseases
摘要
Abstract
Photon-counting computed tomography(PCCT)is a revolutionary technological breakthrough in CT imaging over the past decade.Compared with traditional energy-integrating detector CT,PCCT performs imaging at the single-photon level at the detector layer,offering higher spatial resolution,fewer artifacts,and more accurate spectral imaging.PCCT shows great application potential in the diagnosis of cardiovascular diseases,especially in reducing beam-hardening artifacts and achieving ultra-high spatial resolution,which can further improve the specifi-city and positive predictive value in the assessment of coronary artery stenosis.This also contributes to the accurate evaluation of in-stent restenosis,reliable identification of plaque components,and characterization of vulnerable plaques.PCCT can obtain stable calcium scoring at low radiation doses.The virtual non-contrast(VNC)algo-rithm supports reliable calcium scoring from contrast-enhanced images,further reducing the radiation dose.PCCT can improve the reproducibility of features in pericoronary fat radiomics analysis.The VNC algorithm can accurately assess epicardial fat volume and significantly reduce radiation dose.Spectral images acquired by PCCT at high tem-poral resolution enable single-phase measurement of myocardial extracellular volume.They can also provide multidi-mensional anatomical information and functional parameters for preoperative planning and postoperative follow-up of transcatheter aortic valve implantation/replacement(TAVI/TAVR).Although PCCT holds great potential in the diagnosis of coronary artery disease and quantitative analysis of myocardial tissues,its quantitative results remain affected by reconstruction parameters such as convolution kernels,virtual monoenergetic levels,and iterative strength.Currently,a lack of unified standards and validation from multicenter studies,along with the increased radiation dose in ultra-high-resolution modes,still limits its wide clinical application.Future studies should focus on large-sample,multicenter prospective studies to optimize imaging parameters,standardize post-processing workflows,and integrate artificial intelligence tools to enhance the clinical application of PCCT in cardiovascular disease diagnosis.关键词
光子计数CT/心血管疾病/冠状动脉CT血管成像Key words
Photon-counting computed tomography/Cardiovascular disease/Cardiac CT angiography分类
医药卫生引用本文复制引用
王梦真,鲍守钰,刘鹏,严福华,杨文洁..光子计数CT在心血管疾病中的应用[J].诊断学理论与实践,2025,24(2):125-134,10.基金项目
光子计数能谱CT医学应用研究(2022YFC2401604) （2022YFC2401604）
