Application Of Flexible Splicing CE-Boost Technology In CTA Imaging Of Lower Extremity Arteries

Objective:To evaluate the effect of flexible splicing CE-Boost technology on the image quality and diagnostic effciency of CTA of lower extremity arteries.A total of 50 patients who underwent CTA of both lower extremities in the First Affiliated Hospital of Xinjiang Medical University from December 2021 to December 2022 were collected.Methods:CE-Boost images were obtained by flexible splicing of the conventional hybrid iterative images using Sure-Subtraction Lower limb software.Through Toshiba The CT values and SD values of the vessels and the same muscles in different locations of lower limb arteries(abdominal aortic bifurcation,iliac artery bifurcation,femoral artery,popliteal artery,anterior and posterior tibial artery,peroneal artery,dorsalis pedis artery)of the conventional hybrid iterative images and CE-Boost image were measured by Vitrea post-processing workstation,and the signal to noise ratio(SNR)and contrast to noise ratio(CNR)were calculated.Two radiologists scored the image quality subjectively using a4-point scale,and the difference of image quality between the two groups was evaluated by statistical analysis.For the above 33 patients,DSA was used as the "gold standard" to evaluate the diagnostic efficacy of CE-Boost technology for bilateral lower extremity CTA imaging.Results:The intravascular CT value,SNR and CNR of CE-Boost images at different locations of lower limb arteries(abdominal aortic bifurcation,common iliac artery,common femoral artery,superficial femoral artery,popliteal artery,anterior and posterior tibial artery,peroneal artery and dorsalis pedis artery)were higher than those of conventional hybrid iterative images(all P<0.001).The noise of CE-Boost images was lower than that of the conventional hybrid iterative images(all P<0.001).The subjective scores of two radiologists for CE-Boost images 4(3,4)were higher than that of the original images 3(2,3)(Z=-4.880,P<0.001),and there was a good consistency in the subjective scores of image quality between the two groups(kappa > 0.66,P <0.001).The coincidence rate of CE-Boost CTA in the diagnosis of lower extremity arterial stenosis was 95.90%.The sensitivity,specificity,sensitivity and PPV of CE-Boost CTA in the diagnosis of grade 3(moderate stenosis,50%-74%)and above stenosis in all segments were 98.40%,99.32%,98.75% and 96.09%,respectively.The NPV was 99.54%.The Kappa value of CE-Boost CTA and DSA in the comparison of lower extremity arterial stenosis was 0.964(P<0.001).Conclusion: Flexible subtraction CE-Boost technology can improve the image quality of lower extremity arterial CTA imaging,and has high diagnostic value for lower extremity arterial stenosis.It has high consistency with DSA examination,and can be promoted to clinical application.