陆军军医大学学报2026，Vol.48Issue(4)：461-469,9.DOI:10.16016/j.2097-0927.202511101
优化时间分辨率以降低脑灌注CT辐射剂量:一项基于灌注参数评估的可行性与稳定性研究
Optimizing temporal resolution to reduce radiation dose in cerebral perfusion CT:a feasibility and stability study based on perfusion parameter assessment
摘要
Abstract
Objective To investigate the feasibility of reducing radiation dose in cerebral perfusion CT(CTP)while maintaining diagnostic accuracy by optimizing temporal resolution.Methods This retrospective cohort study included 117 stroke-suspected patients undergoing CTP at the First Affiliated Hospital of Army Medical University from January to September 2025.Three protocols were designed:Protocol 1(full temporal resolution,21-phase acquisition,baseline),Protocol 2(every-other-phase sampling),Protocol 3(peak-enhancement+1/-1 phase retention with every-other-phase sampling for remaining phases).Radiation reduction percentages relative to Protocol 1 were calculated.Regions of interest(ROI)were placed in ischemic core/penumbra to measure mean±SD of perfusion parameters:time to maximum of the residue function(Tmax),mean transit time(MTT),cerebral blood volume(CBV)and cerebral blood flow(CBF).Inter-protocol differences were assessed,and ischemic penumbra volume discrepancies were also analyzed.Results Protocol 2 and 3 reduced radiation dose by 50.0%and 42.9%versus Protocol 1,respectively.For perfusion parameters:Tmax SD differed significantly across protocols[F(1.92,222.42)=11.17,P＜0.001,partial η2=0.09];post hoc tests showed significant mean differences between Protocol 1 vs 2(P＜0.016 7)and Protocol 1 vs 3(P＜0.016 7),but not Protocol 2 vs 3.MTT means showed no significant difference[F(1.88,218.11)=0.47,partial η2=0.004],though SD differed significantly between Protocol 1 vs 2 and 1 vs 3(P＜0.016 7).CBV SD differed significantly[F(1.98,229.25)=22.97,P＜0.001,partial η2=0.17]with no mean difference(Friedman test).CBF means showed no significant difference(Bonferroni-adjusted)but SD differed significantly between Protocol 1 vs 2 and 1 vs 3(P＜0.016 7).Ischemic penumbra volumes differed significantly across all protocols(P＜0.016 7).Conclusion Temporal resolution optimization significantly reduces CTP radiation dose while minimally impacting core perfusion parameters(MTT,CBV,CBF means).CBF remained stable across reduced-dose protocols and may serve as a reliable diagnostic criterion for infarct core delineation.关键词
脑卒中/辐射剂量/脑灌注/体层摄影术/X线计算机Key words
stroke/radiation dose/brain perfusion/tomography/X-Ray computed分类
医药卫生引用本文复制引用
胡钧涛,李穗,刘云..优化时间分辨率以降低脑灌注CT辐射剂量:一项基于灌注参数评估的可行性与稳定性研究[J].陆军军医大学学报,2026,48(4):461-469,9.基金项目
重庆市自然科学基金面上项目(CSTB2023NSCQ-MSX0595) （CSTB2023NSCQ-MSX0595）
陆军军医大学第一附属医院博青创新基金(2024BQCXJJ-7) Supported by the General Program of Natural Science Foundation of Chongqing(CSTB2023NSCQ-MSX0595)and the Youth Innovation Fund for PhDs of the First Affiliated Hospital of Army Medical University(2024BQCXJJ-7). （2024BQCXJJ-7）
