摘要
Abstract
Photon-counting computed tomography(PCCT)is a next-generation CT imaging technology that markedly improves image quality while reducing radiation dose and image noise through single-photon detection and energy discrimination by photon detectors.At present,PCCT holds broad clinical application prospects in the field of neuroimaging,especially demon-strating unique advantages in the visualization of fine intracranial structures,the diagnosis and treatment monitoring of intracra-nial aneurysms,and the diagnosis and treatment of intracranial artery stenosis and spinal vascular lesions.In ultra-high-resolu-tion(UHR)mode(slice thickness of 0.2 mm),PCCT of the head and neck arteries achieves high signal-to-noise ratios using BV64-BV72 convolution kernel reconstruction.With the digital subtraction angiography(DSA)as the gold standard,UHR-PCCTA shows sensitivity,specificity,accuracy,and inter-rater agreement of approximately 98.0%,96.7%,97.3%,and 0.95(Kappa values),respectively,in diagnosing small intracranial aneurysms.In addition,UHR-PCCT significantly outperforms con-ventional energy-integrating detector CT(EID-CT)in identifying aneurysm irregularity,aneurysm wall,and intraluminal features.UHR-PCCT is expected to enable precise evaluation of the degree of arterial stenosis,potentially approaching the accuracy of DSA.With its multi-energy virtual monoenergetic reconstructions,it shows promise for quantitative analysis of intracranial athe-rosclerotic plaques and prediction of plaque rupture risk.Under sharp reconstruction kernels(e.g.,BV72-BV80),PCCT enables clear visualization of intracranial arterial stents and residual aneurysms,offering a new noninvasive alternative to DSA for postope-rative monitoring of intracranial artery treatments.The diversified applications of PCCT in neuroimaging will lay a foundation for its better role in the diagnosis and treatment of neurological diseases.However,the widespread application of PCCT in the neuro-logical field remains limited by factors such as restricted equipment availability,the need for imaging optimization in specific sce-narios(e.g.,small perforating arteries,severe calcifications,or metallic implants),and the lack of support from large-scale clinical validation data.In the future,it is necessary to gradually overcome these limitations through continued hardware upgrades,algo-rithmic optimization,and the advancement of multicenter prospective studies to fully unleash the clinical potential of PCCT.关键词
光子计数CT/神经系统成像/临床应用Key words
Photon-counting CT/Neuroimaging/Clinical application分类
医药卫生
