CAJ | 학술논문

目的评价320层CT冠状动脉成像中前瞻性轴面容积扫描不同kV设置对辐射剂量及图像质量的影响,探讨＜1 mSv冠状动脉检查的可行性及应用价值.方法从拟行冠状动脉成像的患者中连续选取80例,随机分成A、B两组各40例,A组扫描时管电压为100 kV,B组为120 kV.A组经AIDR软件重建后成为A1组.比较A、B两组升主动脉根部平均强化CT值(SI)、噪声(SD)、信噪比(SNR)、对比信噪比(CNR)、有效辐射剂量(E)及图像质量评分.分别比较A、A1和B、A1组间患者SI、SD、SNR、CNR及图像质量评分.结果 A组有效辐射剂量为(0.67±0.18) mSv,B组为(3.08±1.04)mSv(t=- 14.30,P＜0.05),平均减少了78％.A、B两组的图像质量评分分别为(4.57±0.57)和(4.59±0.59)分(t=-1.17,P＞0.05).A、B组SI、SD、SNR、CNR分别为(570.8±131.5)HU、25.1±6.9、24.5±9.1、19.8±6.1和(460.6±14.3)HU、15.1±3.6、31.7±7.7、29.3±6.8.两组SI、SD比较,A组大于B组,差异有统计学意义(t=4.49、8.18,P＜0.05)；SNR、CNR A组小于B组,差异有统计学意义(t=-4.24、-6.19,P＜0.05).A1组SI、SD、SNR、CNR、图像质量评分(557.9±24.5)HU、21.1±6.0、27.7±10.0、23.4±7.8、(4.60±0.56)分,与A组相比,SI、图像质量评分差异无统计学意义(t =1.09、-1.90,P＞0.05)；SD、SNR、CNR差异有统计学意义(t=-5.97、-4.18、-6.22,P＜0.05).结论 320层CT冠状动脉成像前瞻性轴面容积扫描中,采用100 kV管电压扫描,其辐射剂量可降到1mSv以下,并且图像质量达到诊断要求.
목적 평개320층CT관상동맥성상중전첨성축면용적소묘불동kV설치대복사제량급도상질량적영향,탐토＜1 mSv관상동맥검사적가행성급응용개치.방법 종의행관상동맥성상적환자중련속선취80례,수궤분성A、B량조각40례,A조소묘시관전압위100 kV,B조위120 kV.A조경AIDR연건중건후성위A1조.비교A、B량조승주동맥근부평균강화CT치(SI)、조성(SD)、신조비(SNR)、대비신조비(CNR)、유효복사제량(E)급도상질량평분.분별비교A、A1화B、A1조간환자SI、SD、SNR、CNR급도상질량평분.결과 A조유효복사제량위(0.67±0.18) mSv,B조위(3.08±1.04)mSv(t=- 14.30,P＜0.05),평균감소료78％.A、B량조적도상질량평분분별위(4.57±0.57)화(4.59±0.59)분(t=-1.17,P＞0.05).A、B조SI、SD、SNR、CNR분별위(570.8±131.5)HU、25.1±6.9、24.5±9.1、19.8±6.1화(460.6±14.3)HU、15.1±3.6、31.7±7.7、29.3±6.8.량조SI、SD비교,A조대우B조,차이유통계학의의(t=4.49、8.18,P＜0.05)；SNR、CNR A조소우B조,차이유통계학의의(t=-4.24、-6.19,P＜0.05).A1조SI、SD、SNR、CNR、도상질량평분(557.9±24.5)HU、21.1±6.0、27.7±10.0、23.4±7.8、(4.60±0.56)분,여A조상비,SI、도상질량평분차이무통계학의의(t =1.09、-1.90,P＞0.05)；SD、SNR、CNR차이유통계학의의(t=-5.97、-4.18、-6.22,P＜0.05).결론 320층CT관상동맥성상전첨성축면용적소묘중,채용100 kV관전압소묘,기복사제량가강도1mSv이하,병차도상질량체도진단요구.
Objective To evaluate the image quality and radiation dose of prospective electrocardiography-triggered coronary 320-slice volume CT angiography with different kV, and the feasibility of coronary scan with ＜ 1 mSv radiation dose.Methods Eighty consecutive patients were randomly divided into two groups equally.The tube voltage according to paradigm was 100 kV in group A and 120 kV in group B.All raw data in group A was reconstructed by the software AIDR in CT system to create a new group named as A1. Such parameters as the mean intraluminal attenuation (SI),noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),effective radiation dose(E) and image quality score measured in group A were compared with those in group B.The values such as SI,SD,SNR,CNR,image quality scores were compared between group A and group A1.The significance of group B and group A1 was compared in SI,SD,SNR,CNR,image quality scores as well.Results E in group A was significantly lower than that in group B[ E =(0.67 ± 0.18) mSv in group A vs.E =(3.08 ± 1.04) mSv in group B].The value of E in group A was decreased by 78％ compared to group B(t =- 14.30,P＜0.05 ).There was no significant difference in mean image quality scores between two groups(4.57 ± 0.57in groupA vs.4.59 ± 0.59 in group B,t=-1.17,P＞0.05).The values of SI,SD,SNR,CNR in group A were (570.8 ±131.5)HU,25.1 ±6.9,24.5 ±9.1,19.8 ±6.1.And the values of SI,SD,SNR,CNR in group B were (460.6 ± 14.3) HU,15.1 ±3.6,31.7 ±7.7,29.3 ±6.8.The values of SI and SD in group A were significantly higher than those in group B(t =4.49,8.18,P ＜0.05). The values of SNR and CNR in group A were lower than those in group B (t =-4.24,-6.19,P＜0.05).The valuesofS1,SD,SNR,CNR,image quality scores in group Al were (557.9 ±24.5) HU,21.1 ±6.0,27.7±10.0,23.4±7.8,4.60 ± 0.56.There was no difference in the SI and the image quality scores between group A and group A1 ( t =1.09,- 1.90,P ＞ 0.05).Conclusions 320-slice volume CT with 100 kV tube voltage and prospective ECG-triggered technique can reduce the radiation dose to less than 1 mSv and obtain optimal images in diagnosis of coronary arterial diseases.