中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2014年
2期
109-113
,共5页
王怡宁%曹剑%孔令燕%林路%薛华丹%李烁%宋兰%王志伟%周慷
王怡寧%曹劍%孔令燕%林路%薛華丹%李爍%宋蘭%王誌偉%週慷
왕이저%조검%공령연%림로%설화단%리삭%송란%왕지위%주강
冠状血管%体层摄影术,X线计算机%血管造影术%辐射剂量
冠狀血管%體層攝影術,X線計算機%血管造影術%輻射劑量
관상혈관%체층섭영술,X선계산궤%혈관조영술%복사제량
Coronary vessel%Tomography,X-ray computed%Angiography%Radiation dosage
目的 评估应用第二代双源CT新型探测器对患者进行低管电压(80 kV)冠状动脉CTA的应用价值.方法 将103例临床怀疑或已知冠心病的患者采用简单随机分组.分别以第二代双源CT普通探测器(A组)和新型探测器(B组)进行前瞻性心电触发序列扫描,A组管电压为100 kV,对原始数据进行滤波反投影(FBP)重建,B组管电压为80 kV,对原始数据进行FBP(B1组)和迭代(B2组)重建.各组CT图像的辐射剂量[CT剂量容积指数(CTDIvol)和有效剂量(ED)]以及背景噪声绝对值、主动脉根部CT值、图像信噪比(SNR)、冠状动脉近段的对比噪声比(CNR)进行系统测量.由2名放射科医师采用双盲法对每例患者冠状动脉的图像质量进行4分法评估.应用独立样本t检验比较2组患者辐射剂量(CTDIvol和ED).应用ANOVA单因素方差分析比较A、B1和B2组主动脉根部CT值、图像噪声、SNR和冠状动脉近段CNR.应用卡方检验比较3组冠状动脉平均分可评价节段数百分比.用Kappa分析评价不同观察者冠状动脉图像质量评分的一致性.结果A组52例、B组51例患者,B组CTDIvol和ED显著低于A组,2组CTDIvol分别为(8.93 ±2.55)和(13.87 ±4.62) mGy(t =6.71,P＜0.01),ED分别为(1.77±0.51)和(2.65±0.89)mSv(t =6.09,P＜0.01).B1组图像噪声显著高于A组和B2组(A、B1和B2组分别为:30.52±4.45、41.17±7.68和30.91 ±6.04；F=48.75,P＜0.01).B2组图像SNR(A、B1和B2组分别为:17.50±3.40、17.13±4.51和22.85±5.79,F=24.12)及冠状动脉近段CNR[A、B1和B2组分别为:(左主干)23.35±6.20、27.78±6.90、38.49±12.48,F=38.70；(右冠状动脉)23.61±6.18、28.83 ±6.54、39.81±11.65,F=48.77]显著高于A和B1组(P值均＜0.01).图像质量评分:A组(1.29±0.23)分,B1组(1.34±0.29)分,B2组(1.33±0.31)分；3组可评价血管段的百分比[96.9％ (813/839)、96.2％(789/820)、96.5％ (791/820)],差异无统计学意义(x2=1.81,P ＞0.05).结论 在装备新型整合回路探测器的第二代双源CT上应用80 kV低管电压结合迭代重建进行冠状动脉CTA检查可以显著降低放射剂量,并获得可供临床评价的图像质量.
目的 評估應用第二代雙源CT新型探測器對患者進行低管電壓(80 kV)冠狀動脈CTA的應用價值.方法 將103例臨床懷疑或已知冠心病的患者採用簡單隨機分組.分彆以第二代雙源CT普通探測器(A組)和新型探測器(B組)進行前瞻性心電觸髮序列掃描,A組管電壓為100 kV,對原始數據進行濾波反投影(FBP)重建,B組管電壓為80 kV,對原始數據進行FBP(B1組)和迭代(B2組)重建.各組CT圖像的輻射劑量[CT劑量容積指數(CTDIvol)和有效劑量(ED)]以及揹景譟聲絕對值、主動脈根部CT值、圖像信譟比(SNR)、冠狀動脈近段的對比譟聲比(CNR)進行繫統測量.由2名放射科醫師採用雙盲法對每例患者冠狀動脈的圖像質量進行4分法評估.應用獨立樣本t檢驗比較2組患者輻射劑量(CTDIvol和ED).應用ANOVA單因素方差分析比較A、B1和B2組主動脈根部CT值、圖像譟聲、SNR和冠狀動脈近段CNR.應用卡方檢驗比較3組冠狀動脈平均分可評價節段數百分比.用Kappa分析評價不同觀察者冠狀動脈圖像質量評分的一緻性.結果A組52例、B組51例患者,B組CTDIvol和ED顯著低于A組,2組CTDIvol分彆為(8.93 ±2.55)和(13.87 ±4.62) mGy(t =6.71,P＜0.01),ED分彆為(1.77±0.51)和(2.65±0.89)mSv(t =6.09,P＜0.01).B1組圖像譟聲顯著高于A組和B2組(A、B1和B2組分彆為:30.52±4.45、41.17±7.68和30.91 ±6.04；F=48.75,P＜0.01).B2組圖像SNR(A、B1和B2組分彆為:17.50±3.40、17.13±4.51和22.85±5.79,F=24.12)及冠狀動脈近段CNR[A、B1和B2組分彆為:(左主榦)23.35±6.20、27.78±6.90、38.49±12.48,F=38.70；(右冠狀動脈)23.61±6.18、28.83 ±6.54、39.81±11.65,F=48.77]顯著高于A和B1組(P值均＜0.01).圖像質量評分:A組(1.29±0.23)分,B1組(1.34±0.29)分,B2組(1.33±0.31)分；3組可評價血管段的百分比[96.9％ (813/839)、96.2％(789/820)、96.5％ (791/820)],差異無統計學意義(x2=1.81,P ＞0.05).結論 在裝備新型整閤迴路探測器的第二代雙源CT上應用80 kV低管電壓結閤迭代重建進行冠狀動脈CTA檢查可以顯著降低放射劑量,併穫得可供臨床評價的圖像質量.
목적 평고응용제이대쌍원CT신형탐측기대환자진행저관전압(80 kV)관상동맥CTA적응용개치.방법 장103례림상부의혹이지관심병적환자채용간단수궤분조.분별이제이대쌍원CT보통탐측기(A조)화신형탐측기(B조)진행전첨성심전촉발서렬소묘,A조관전압위100 kV,대원시수거진행려파반투영(FBP)중건,B조관전압위80 kV,대원시수거진행FBP(B1조)화질대(B2조)중건.각조CT도상적복사제량[CT제량용적지수(CTDIvol)화유효제량(ED)]이급배경조성절대치、주동맥근부CT치、도상신조비(SNR)、관상동맥근단적대비조성비(CNR)진행계통측량.유2명방사과의사채용쌍맹법대매례환자관상동맥적도상질량진행4분법평고.응용독립양본t검험비교2조환자복사제량(CTDIvol화ED).응용ANOVA단인소방차분석비교A、B1화B2조주동맥근부CT치、도상조성、SNR화관상동맥근단CNR.응용잡방검험비교3조관상동맥평균분가평개절단수백분비.용Kappa분석평개불동관찰자관상동맥도상질량평분적일치성.결과A조52례、B조51례환자,B조CTDIvol화ED현저저우A조,2조CTDIvol분별위(8.93 ±2.55)화(13.87 ±4.62) mGy(t =6.71,P＜0.01),ED분별위(1.77±0.51)화(2.65±0.89)mSv(t =6.09,P＜0.01).B1조도상조성현저고우A조화B2조(A、B1화B2조분별위:30.52±4.45、41.17±7.68화30.91 ±6.04；F=48.75,P＜0.01).B2조도상SNR(A、B1화B2조분별위:17.50±3.40、17.13±4.51화22.85±5.79,F=24.12)급관상동맥근단CNR[A、B1화B2조분별위:(좌주간)23.35±6.20、27.78±6.90、38.49±12.48,F=38.70；(우관상동맥)23.61±6.18、28.83 ±6.54、39.81±11.65,F=48.77]현저고우A화B1조(P치균＜0.01).도상질량평분:A조(1.29±0.23)분,B1조(1.34±0.29)분,B2조(1.33±0.31)분；3조가평개혈관단적백분비[96.9％ (813/839)、96.2％(789/820)、96.5％ (791/820)],차이무통계학의의(x2=1.81,P ＞0.05).결론 재장비신형정합회로탐측기적제이대쌍원CT상응용80 kV저관전압결합질대중건진행관상동맥CTA검사가이현저강저방사제량,병획득가공림상평개적도상질량.
Objective To investigate the value of low tube voltage (80 kV) for coronary computed tomography angiography (CCTA) in patients with normal body mass index (BMI) on 128-slice dual-source CT with novel high sensitive integrated circuit (IC) detector.Methods One hundred and three consecutive patients were scanned using prospectively ECG-triggered sequential CCTA protocol.All patients were randomly divided into group A and B.Group A was examined on a conventional 128-slice dual-source CT,while group B on a 128-slice dual-source CT with high sensitive integrated circuit detector.The tube voltage of group A was 100 kV and raw data was reconstructed with filtered back projection (FBP),while tube voltage of group B was 80 kV and raw data was reconstructed with both FBP (Subgroup B1) and sonogramaffirmed iterative reconstruction (SAFIRE) (Subgroup B2).The differences in background noise,signal-tonoise ratio (SNR),contrast-to-noise ratio (CNR),CT dose index volume (CTDIvol),effective dose (ED),and image quality between the groups were compared by using t test,ANOVA and x2 test.Results There were no significant differences in age,BMI or heart rate between the two groups (Group A,n =52 vs.Group B,n =51).Radiation exposure (CTDIvol and ED) of group B was significantly lower than that of group A [(8.93 ±2.55) vs.(13.87 ±4.62) mGy and (1.77 ±0.51)vs.(2.65 ±0.89) mSv,t =6.71,6.09,all P ＜ 0.01].SNR and CNR of proximal coronary arteries in group B2 were significantly higher than group A and B1,and there was no significant difference between the latter two.In group A,mean score of total 839 coronary artery segments was 1.29 ± 0.23,and the number of evaluable segments was 813 (96.9％).In group B1,mean score of total 820 coronary artery segments was 1.34 ± 0.29,and the number of evaluable segments was 789 (96.2％).In group B2,mean score of total 820 coronary artery segments was 1.33 ± 0.31,and the number of was 791 (96.5％).There were no significant differences in both mean score and percentage of evaluable segments between three groups (x2 =1.81,P ＞ 0.05).Conclusion Using 80 kV tube voltage on 128-slice dual-source CT equipped with novel integrated circuit detector and combining iterative reconstruction is feasible in patients with normal BMI,with the benefits of significantly reduced radiation dose and adequate image quality.
