国际医学放射学杂志2026，Vol.49Issue(2)：131-136,177,7.DOI:10.19300/j.2026.L22566
60kVp管电压联合人工智能迭代重建在上肢血管内瘘CTA中的应用
Application of 60 kVp tube voltage combined with artificial intelligence iterative reconstruction in CT angiography of upper limb arteriovenous fistula
摘要
Abstract
Objective To investigate the application and value of ultra-low tube voltage(60 kVp)combined with an artificial intelligence iterative reconstruction(AIIR,United Imaging Healthcare uExceed R001)in CT angiography(CTA)of upper limb arteriovenous fistula.Methods Ninety patients with chronic renal failure undergoing upper limb arteriovenous fistula CTA were prospectively enrolled.Using a random number table,they wer randomly assigned to a conventional dose group(100 kVp,1.0 mL/kg contrast medium,hybrid iterative reconstruction;n=45)and an ultra-low dose group(60 kVp,0.5 mL/kg contrast medium,AIIR reconstruction;n=45).Two senior radiologists independently assessed subjective image quality and diagnostic confidence for anastomotic stenosis using a 4-point scale.Cohen's Kappa was used to evaluate inter-observer agreement.The radiologists quantitatively analyzed the mean CT attenuation,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)at the subclavian,brachial artery,and radial artery levels.Radiation dose and contrast medium usage were compared between the two groups.Differences between the two groups were compared using the independent sample t-test,Mann-Whitney U test or chi-square test.Results There were no statistically significant differences in age,sex,body weight,and body mass index between the two groups(P>0.05).Image quality and fistula diagnostic confidence scores were≥3 points,meeting clinical diagnostic requirements,with good interobserver agreement(Kappa>0.72).Quantitative measurements showed that the ultra-low dose group had significantly higher SNR and CNR values at all measured vascular levels compared with the conventional dose group(all P<0.001),including the subclavian artery,brachial artery,and radial artery.The effective radiation dose in the ultra-low dose group was significantly lower than that in the conventional dose group(1.28 mSv vs.6.50 mSv,P<0.001),reduced by approximately 80%.Contrast medium volume decreased from 61.0 mL to 28.5 mL(53%reduction),and iodine load decreased from 21.35 g to 11.40 g(47%reduction).Conclusion Ultra-low dose combined with AIIR in upper limb arteriovenous fistula CTA can significantly reduce radiation dose and contrast medium usage while maintaining or improving image quality and diagnostic confidence.It demonstrates potential clinical value,particularly suitable for high-frequency follow-up in dialysis patients.关键词
血管内瘘/CT血管成像/人工智能迭代重建/低剂量CT/低剂量对比剂/体层摄影术,X线计算机Key words
Arteriovenous fistula/CT angiography/Artificial intelligence iterative reconstruction/Low dose CT/Low contrast dose/Tomogrophy,X-ray computed分类
医药卫生引用本文复制引用
胡溪,李静,寿蓓丽,张文明,周扬恒,张月俏,胡红杰..60kVp管电压联合人工智能迭代重建在上肢血管内瘘CTA中的应用[J].国际医学放射学杂志,2026,49(2):131-136,177,7.基金项目
浙江省"尖兵领雁+X"科技计划项目(2026C02A1129) （2026C02A1129）
浙江省卫生健康行业科技计划(2025HY0432) （2025HY0432）
