中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
5期
486-491
,共6页
何新华%胡永胜%王自勇%付璇%王劲武%杨越%王慧%费长军
何新華%鬍永勝%王自勇%付璇%王勁武%楊越%王慧%費長軍
하신화%호영성%왕자용%부선%왕경무%양월%왕혜%비장군
冠状血管%体重%体层摄影术,螺旋计算机%辐射剂量
冠狀血管%體重%體層攝影術,螺鏇計算機%輻射劑量
관상혈관%체중%체층섭영술,라선계산궤%복사제량
Coronary vessels%Body weight%Tomography,spiral computed%Radiation dosage
目的 探讨在超重患者双源CT冠状动脉成像中低管电压技术的应用价值,评价其图像质量和辐射剂量.方法 将66例接受双源CT冠状动脉检查,体质量<85 kg、且体质量指数(BMI)为25.0～30.0 ks/m2的患者完全随机化分为A、B 2组.A组30例,管电压为120 kVp;B组36例,管电压为100 kVp.所有患者均采用回顾性心电门控螺旋扫描和四维智能在线剂量调控(CARE Dose 4D)技术,严格控制扫描范围.对2组的扫描数据分别进行多种图像后处理,由影像科副主任医师和副主任技师各1名采用双盲法评估图像质量.测量并计算信噪比(SNR)、对比信噪比(CNR).记录CT容积剂量指数(CTDIvol)和剂量长度乘积(DLP),计算有效辐射剂量(ED).应用两独立样本t检验比较2组患者图像ROI的CT值、噪声、SNR、CNR、辐射剂量及对比剂用量、图像质量评分等.应用X2检验比较两组患者冠状动脉图像质量分级显示段数.应用Kappa检验判断2名评价者评分的一致性.以P<0.05为差异有统计学意义.结果 图像ROI内CT值、噪声(以标准差SD计算)、SNR测量值:A组右冠状动脉(RCA)起始部分别为(429.3±77.4)HU,24.0±8.2、21.8±9.9,左冠状动脉主干(LMA)起始部分别为(436.7±79.0)HU、19.4±7.3、22.3±9.8;B组RCA分别为(503.5±95.4)HU、34.0±12.6、21.0±10.7,LMA分别为(491.7±96.2)HU、33.4±15.5、20.6±11.4;CNR测量值:A组为24.4±10.3,B组为21.9±8.2.2组患者冠状动脉血管腔内强化平均CT值、噪声比较,B组大于A组,差异有统汁学意义(P值均<0.05);2组间SNR、CNR筹异无统计学意义(P值均>0.05);2组CTDIvol比较,A组为(42.2±13.8)mGy,B组为(20.2±6.5)mGy,差异有统计学意义(P<0.05);A组ED为(9.5±3.6)roSy,B组为(4.8±1.7)mSv,差异有统汁学意义(P<0.05);A组图像质量评分为(4.5±1.0)分,B组为(4.7±0.5)分,筹异无统计学意义(P>0.05);A绀评价383段冠状动脉,图像优良者377段(98.4%)B组评价490段冠状动脉,图像优良者483段(98.6%).结论 对于BMI在25.0～30.0 kg/m2的患者,使用100 kVp管电压配合CARE Dose 4D技术进行双源CT冠状动脉检查,可以获得较好的图像质量,并且可以显著降低辐射剂量.
目的 探討在超重患者雙源CT冠狀動脈成像中低管電壓技術的應用價值,評價其圖像質量和輻射劑量.方法 將66例接受雙源CT冠狀動脈檢查,體質量<85 kg、且體質量指數(BMI)為25.0～30.0 ks/m2的患者完全隨機化分為A、B 2組.A組30例,管電壓為120 kVp;B組36例,管電壓為100 kVp.所有患者均採用迴顧性心電門控螺鏇掃描和四維智能在線劑量調控(CARE Dose 4D)技術,嚴格控製掃描範圍.對2組的掃描數據分彆進行多種圖像後處理,由影像科副主任醫師和副主任技師各1名採用雙盲法評估圖像質量.測量併計算信譟比(SNR)、對比信譟比(CNR).記錄CT容積劑量指數(CTDIvol)和劑量長度乘積(DLP),計算有效輻射劑量(ED).應用兩獨立樣本t檢驗比較2組患者圖像ROI的CT值、譟聲、SNR、CNR、輻射劑量及對比劑用量、圖像質量評分等.應用X2檢驗比較兩組患者冠狀動脈圖像質量分級顯示段數.應用Kappa檢驗判斷2名評價者評分的一緻性.以P<0.05為差異有統計學意義.結果 圖像ROI內CT值、譟聲(以標準差SD計算)、SNR測量值:A組右冠狀動脈(RCA)起始部分彆為(429.3±77.4)HU,24.0±8.2、21.8±9.9,左冠狀動脈主榦(LMA)起始部分彆為(436.7±79.0)HU、19.4±7.3、22.3±9.8;B組RCA分彆為(503.5±95.4)HU、34.0±12.6、21.0±10.7,LMA分彆為(491.7±96.2)HU、33.4±15.5、20.6±11.4;CNR測量值:A組為24.4±10.3,B組為21.9±8.2.2組患者冠狀動脈血管腔內彊化平均CT值、譟聲比較,B組大于A組,差異有統汁學意義(P值均<0.05);2組間SNR、CNR籌異無統計學意義(P值均>0.05);2組CTDIvol比較,A組為(42.2±13.8)mGy,B組為(20.2±6.5)mGy,差異有統計學意義(P<0.05);A組ED為(9.5±3.6)roSy,B組為(4.8±1.7)mSv,差異有統汁學意義(P<0.05);A組圖像質量評分為(4.5±1.0)分,B組為(4.7±0.5)分,籌異無統計學意義(P>0.05);A紺評價383段冠狀動脈,圖像優良者377段(98.4%)B組評價490段冠狀動脈,圖像優良者483段(98.6%).結論 對于BMI在25.0～30.0 kg/m2的患者,使用100 kVp管電壓配閤CARE Dose 4D技術進行雙源CT冠狀動脈檢查,可以穫得較好的圖像質量,併且可以顯著降低輻射劑量.
목적 탐토재초중환자쌍원CT관상동맥성상중저관전압기술적응용개치,평개기도상질량화복사제량.방법 장66례접수쌍원CT관상동맥검사,체질량<85 kg、차체질량지수(BMI)위25.0～30.0 ks/m2적환자완전수궤화분위A、B 2조.A조30례,관전압위120 kVp;B조36례,관전압위100 kVp.소유환자균채용회고성심전문공라선소묘화사유지능재선제량조공(CARE Dose 4D)기술,엄격공제소묘범위.대2조적소묘수거분별진행다충도상후처리,유영상과부주임의사화부주임기사각1명채용쌍맹법평고도상질량.측량병계산신조비(SNR)、대비신조비(CNR).기록CT용적제량지수(CTDIvol)화제량장도승적(DLP),계산유효복사제량(ED).응용량독립양본t검험비교2조환자도상ROI적CT치、조성、SNR、CNR、복사제량급대비제용량、도상질량평분등.응용X2검험비교량조환자관상동맥도상질량분급현시단수.응용Kappa검험판단2명평개자평분적일치성.이P<0.05위차이유통계학의의.결과 도상ROI내CT치、조성(이표준차SD계산)、SNR측량치:A조우관상동맥(RCA)기시부분별위(429.3±77.4)HU,24.0±8.2、21.8±9.9,좌관상동맥주간(LMA)기시부분별위(436.7±79.0)HU、19.4±7.3、22.3±9.8;B조RCA분별위(503.5±95.4)HU、34.0±12.6、21.0±10.7,LMA분별위(491.7±96.2)HU、33.4±15.5、20.6±11.4;CNR측량치:A조위24.4±10.3,B조위21.9±8.2.2조환자관상동맥혈관강내강화평균CT치、조성비교,B조대우A조,차이유통즙학의의(P치균<0.05);2조간SNR、CNR주이무통계학의의(P치균>0.05);2조CTDIvol비교,A조위(42.2±13.8)mGy,B조위(20.2±6.5)mGy,차이유통계학의의(P<0.05);A조ED위(9.5±3.6)roSy,B조위(4.8±1.7)mSv,차이유통즙학의의(P<0.05);A조도상질량평분위(4.5±1.0)분,B조위(4.7±0.5)분,주이무통계학의의(P>0.05);A감평개383단관상동맥,도상우량자377단(98.4%)B조평개490단관상동맥,도상우량자483단(98.6%).결론 대우BMI재25.0～30.0 kg/m2적환자,사용100 kVp관전압배합CARE Dose 4D기술진행쌍원CT관상동맥검사,가이획득교호적도상질량,병차가이현저강저복사제량.
Objective To investigate the image quality and the radiation dose of dual-source computed tomography coronary angiography by using low kilovohage combination with low tube current in overweight patients.Methods Sixty-six patients with body mass inde,(BMI)25.(0-30.0 kg/m2 and a body weight<85 kg were randomized two groups(group A and group B).Thirty patients in group A were examined with 120 kVp,and 36 patients in group B with 100 kVp.ECG-pulsing and care dose 4D for radiation dose reduction were used in all patients.All images were transferred to Siemens workstation for post processing and analysis.Two observers blimted to clinical data independently assessed the image quality of each coronary segment by using a 5-point scoring scale(5:excellent,1:no diagnostic).and measured the different image parameters including image noise,signal-to-noise ratio(SNR)and contrast-to-noise ratio (CNR).The effective dose(ED)was calculated by using CT dose volume index(CTDIvol)and the doselength product (DLP). The mean intraluminal attenuation, image noise, SNR, CNR, radiation dose,volume of contrast medium, and mean image quality scores were compared between the two groups with t test. The grading quantity of coronary artery segment was compared with Chi-square test. The interobserver agreement was determined by Kappa statistics. Results The mean intraluminal attenuation, image noise,SNR in group A were (429. 3±77.4 ) HU, 24.0±8.2, 21.8±9. 9 in right coronary artery ( RCA), and (436. 7±79. 0) HU, 19.4±7.3, 22. 3±9. 8 in left main coronary artery (LMA ), and that in group B were (503.5±95.4) HU, 34.0±12.6, 21.0±10.7 in RCA, and (491.7±96.2) HU, 33.4±15.5,20.6±11.4 in LMA. The CNR were 24.4±10.3 in group A and 21.9±8.2 in group B. The mean intraluminal attenuation and image noise were significantly higher for group B compared with group A ( P <0. 05 ). There were no difference in SNR and CNR between the two groups ( P > 0. 05 ). Estimated ED in group B was significantly lower than that in group A [CTDIvol = (42. 2±13. 8) mGy, ED = (9. 5±3.6)mSv in group A vs. CTDIvol = ( 20. 2±6.5 ) mGy, ED = (4. 8±1.7 ) mSv in group B ; each P < 0. 05 ].Mean image quality scores were not significantly different between two groups ( 4. 5±1.0 in group A vs.4. 7±0. 5 in group B, P > 0. 05 ). A total of 383 coronary artery segments were evaluated in group A and 490 segments in group B. The difference of grading quantity of coronary artery segment was no statistical significant between two groups. Conclusions 100 kVp combination with ECC-pulsing and CARE Dose 4D of dual-source CTCA was valuable for patients with BMI ranging from 25 to 30 kg/m2 which have a better image quality and low radiatiun dose.
