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目的提出系统性文献检索的结果。旨在确定迭代重建技术(IR)在心肺与体部CT成像的临床应用中减少放射剂量的程度,以及与滤波反投影(FBP)相比IR对影像质量的影响,并对未来的IR研究提出建议。方法检索2006年1月—2012年1月的Medline与Embase数据库,纳入关于IR的CT原创性研究论文。结果本系统评价检出380篇论文。纳入49篇相关性研究。研究涉及胸(n=26)、腹(n=16)、胸与腹(n=1)、头(n=4),脊柱(n=1)和非特定区域(n=1)。相同放射剂量下,IR与FBP比较,减少了噪声与伪影,改善了主、客观影像质量。低剂量IR与常规剂量FBP比较,噪声、伪影及主、客观影像质量相似。报告显示,与当地应用的FBP默认设置比较,剂量减低程度为23%~76%。然而,尚未见以临床诊断与准确性为端点的超低剂量检查的研究。结论 IR的优势包括改善主、客观影像质量,以及减少放射剂量的同时能保持影像质量。未来的研究需关注有临床相关端点的超低剂量CT的IR价值。要点①迭代重建在相同的扫描参数下改善了CT影像质量。②与常规剂量的滤波反投影比较,IR保持了影像质量。③IR能减少放射剂量,使病人受益。④目前尚无临床诊断与准确性作为端点的IR研究。
Objective To propose the results of systematic literature search. To determine the extent to which Iterative Reconstruction Techniques (IR) reduce the dose of radiation in clinical applications of cardiopulmonary and body CT imaging and the impact of IR on image quality compared to filtered backprojection (FBP), and to propose future IR studies Suggest. Methods We searched the Medline and Embase databases from January 2006 to January 2012 and included CT original research papers on IR. Results This systematic review detected 380 papers. 49 related studies were included. The study involved chest (n = 26), abdomen (n = 16), chest and abdomen (n = 1), head (n = 4), spine (n = 1) and non-specific area (n = 1). The same radiation dose, IR and FBP compared to reduce noise and artifacts, improve the main and objective image quality. Low dose IR compared with conventional dose FBP, noise, artifacts and the main and objective image quality is similar. The report shows a dose reduction of 23% to 76% compared to the locally applied FBP default settings. However, no studies have been done on ultralow-dose testing that endpoints clinical diagnosis and accuracy. Conclusion The advantages of IR include improving the primary and objective image quality and reducing the radiation dose while maintaining image quality. Future studies need to focus on the IR value of ultra-low-dose CT with clinically relevant end points. Points ① Iterative reconstruction improves CT image quality with the same scan parameters. ② Compared with the normal dose of filtered backprojection, IR maintains the image quality. IR can reduce the radiation dose, make the patient benefit. ④ There is currently no clinical diagnosis and accuracy as the endpoint of the IR study.