放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2014年
6期
589-592
,共4页
曹剑%易妍%王怡宁%林路%王明%孔令燕%薛华丹%宋兰%王志伟%王少华%张龙江%卢光明%金征宇
曹劍%易妍%王怡寧%林路%王明%孔令燕%薛華丹%宋蘭%王誌偉%王少華%張龍江%盧光明%金徵宇
조검%역연%왕이저%림로%왕명%공령연%설화단%송란%왕지위%왕소화%장룡강%로광명%금정우
冠状动脉疾病%体层摄影术,X线计算机%CT血管成像%辐射剂量
冠狀動脈疾病%體層攝影術,X線計算機%CT血管成像%輻射劑量
관상동맥질병%체층섭영술,X선계산궤%CT혈관성상%복사제량
Coronary artery disease%Tomography,X-ray computed%Angiography%Radiation dose
目的：通过与常规对比剂用量方案对比，探讨在装备整合回路探测器的双源CT 上应用70 kV 超低管电压、低对比剂流率和低对比剂用量的方案对体重指数正常（BMI≤25 kg/m2）的患者行冠状动脉 CTA 检查的可行性。方法：应用装备整合回路探测器的双源CT对50例BMI≤25 kg/m2的患者行前瞻性心电触发序列扫描。所有患者被随机分为两组：A组对比剂流率和用量分别为4．0和32 mL （350 mg I/mL），B组对比剂流率和剂量为4．0和50 mL （350 mg I/mL）。两组管电压均采用70 kV，对原始数据进行SAFIRE迭代重建。比较两组患者的年龄、BMI和心率，比较两组图像的背景噪声、信噪比和放射剂量，测量并比较两组图像冠脉各节段的管腔内的CT 值和图像对比噪声比。以段为单位，对两组的冠脉图像质量采用4分法（1～4分，优-无法评估）进行比较。结果：两组患者在年龄、B MI和心率方面无显著性差异，两组图像的背景噪声、信噪比和放射剂量方面无显著性差异（P＞0．05），平均有效辐射剂量约为0．9 mSv。3支冠脉主干远段CT值的比较，B组显著高于A组；而冠脉近、中段及主动脉根部CT 值的比较两组无显著性差异。在冠脉各节段对比噪声比方面，B组均显著高于A组（P＜0．05）。以段为单位，两组冠脉图像质量平均评分无显著性差异（A组1．16±0．18，B组1．18±0．18，P＝0．75）。两组冠脉可评价节段率均＞98％。结论：在装备整合回路探测器的双源CT 上对正常体重指数患者应用70 kV超低管电压、低对比剂流率和低对比剂用量的方案进行冠状动脉CTA 的检查可以在亚毫希伏条件下获得满足临床诊断的图像质量，较常规方案对比剂用量显著减低。
目的：通過與常規對比劑用量方案對比，探討在裝備整閤迴路探測器的雙源CT 上應用70 kV 超低管電壓、低對比劑流率和低對比劑用量的方案對體重指數正常（BMI≤25 kg/m2）的患者行冠狀動脈 CTA 檢查的可行性。方法：應用裝備整閤迴路探測器的雙源CT對50例BMI≤25 kg/m2的患者行前瞻性心電觸髮序列掃描。所有患者被隨機分為兩組：A組對比劑流率和用量分彆為4．0和32 mL （350 mg I/mL），B組對比劑流率和劑量為4．0和50 mL （350 mg I/mL）。兩組管電壓均採用70 kV，對原始數據進行SAFIRE迭代重建。比較兩組患者的年齡、BMI和心率，比較兩組圖像的揹景譟聲、信譟比和放射劑量，測量併比較兩組圖像冠脈各節段的管腔內的CT 值和圖像對比譟聲比。以段為單位，對兩組的冠脈圖像質量採用4分法（1～4分，優-無法評估）進行比較。結果：兩組患者在年齡、B MI和心率方麵無顯著性差異，兩組圖像的揹景譟聲、信譟比和放射劑量方麵無顯著性差異（P＞0．05），平均有效輻射劑量約為0．9 mSv。3支冠脈主榦遠段CT值的比較，B組顯著高于A組；而冠脈近、中段及主動脈根部CT 值的比較兩組無顯著性差異。在冠脈各節段對比譟聲比方麵，B組均顯著高于A組（P＜0．05）。以段為單位，兩組冠脈圖像質量平均評分無顯著性差異（A組1．16±0．18，B組1．18±0．18，P＝0．75）。兩組冠脈可評價節段率均＞98％。結論：在裝備整閤迴路探測器的雙源CT 上對正常體重指數患者應用70 kV超低管電壓、低對比劑流率和低對比劑用量的方案進行冠狀動脈CTA 的檢查可以在亞毫希伏條件下穫得滿足臨床診斷的圖像質量，較常規方案對比劑用量顯著減低。
목적：통과여상규대비제용량방안대비，탐토재장비정합회로탐측기적쌍원CT 상응용70 kV 초저관전압、저대비제류솔화저대비제용량적방안대체중지수정상（BMI≤25 kg/m2）적환자행관상동맥 CTA 검사적가행성。방법：응용장비정합회로탐측기적쌍원CT대50례BMI≤25 kg/m2적환자행전첨성심전촉발서렬소묘。소유환자피수궤분위량조：A조대비제류솔화용량분별위4．0화32 mL （350 mg I/mL），B조대비제류솔화제량위4．0화50 mL （350 mg I/mL）。량조관전압균채용70 kV，대원시수거진행SAFIRE질대중건。비교량조환자적년령、BMI화심솔，비교량조도상적배경조성、신조비화방사제량，측량병비교량조도상관맥각절단적관강내적CT 치화도상대비조성비。이단위단위，대량조적관맥도상질량채용4분법（1～4분，우-무법평고）진행비교。결과：량조환자재년령、B MI화심솔방면무현저성차이，량조도상적배경조성、신조비화방사제량방면무현저성차이（P＞0．05），평균유효복사제량약위0．9 mSv。3지관맥주간원단CT치적비교，B조현저고우A조；이관맥근、중단급주동맥근부CT 치적비교량조무현저성차이。재관맥각절단대비조성비방면，B조균현저고우A조（P＜0．05）。이단위단위，량조관맥도상질량평균평분무현저성차이（A조1．16±0．18，B조1．18±0．18，P＝0．75）。량조관맥가평개절단솔균＞98％。결론：재장비정합회로탐측기적쌍원CT 상대정상체중지수환자응용70 kV초저관전압、저대비제류솔화저대비제용량적방안진행관상동맥CTA 적검사가이재아호희복조건하획득만족림상진단적도상질량，교상규방안대비제용량현저감저。
Objective:To investigate the application of ultra low tube voltage (70kV)for coronary artery CT angiog-raphy (CCTA)with low-volume contrast media and low inj ection rate on dual-source CT (DSCT)equipment with integrat-ed circuit (IC)detector.Methods:Fifty patients with body mass index (BMI)not more than 25kg/m2 were scanned with a prospectively ECG-triggering sequential CCTA protocol on DSCT.All patients were randomly divided into two groups:the injection rate and volume of contrast in Group A was 4.0ml/s and 32mL (350mg I/mL);those in Group B were 4.0mL/s and 50mL (350mg I/mL),respectively.Tube voltage of both groups was 70kV.The raw data were reconstructed with sino-gram affirmed iterative reconstruction (SAFIRE)technique.The differences of age,BMI,heart rate,background noise,sig-nal-to-noise ratio (SNR)and radiation dose between the two Groups were compared.Besides,the CT value and CNR of the aortic root and each segment of coronary arteries were compared.And Image quality (1~4,excellent to non-assessable)be-tween the two Groups was compared segment-based.Results:There were no significant differences in age,BMI,heart rate, background noise,SNR or radiation dose between the two Groups (all P>0.05),and the mean ED was about 0.90mSv.The CT value of the distal segment of each coronary arteries in Group B was higher than Group A,while there were no signifi-cant differences in the proximal and median segments between the two groups.However,the CNR of each segment of coro-nary arteries in Group B were higher than Group A (all P<0.01).Mean segment-based image quality scores showed no sig-nificant difference between the two Groups reconstructed with SAFIRE (Group A,1.16±0.18,Group B,1.18±0.18;P=0.75).The percentage of assessable segments in each Group were more than 98%.Conclusion:For patients with normal BMI,the use of tube voltage as 70kV with SAFIRE technique in DSCT equipped IC detector is feasible.And both the con-trast injection rate and volume can be much lower.
