CAJ | 학술논문

目的：探讨低电压、低浓度碘对比剂在冠状动脉 CTA 成像应用过程中降低 X 线辐射剂量的可行性研究。方法选取CCTA 检查患者80例,分为4组,每组20例：Ⅰ组和Ⅱ组采用120 kV,350 mA,碘海醇350 mg I/mL,Ⅰ组使用滤波反投影重建算法(FBP),Ⅱ组使用自适应统计迭代重建算法(ASIR)；Ⅲ组和Ⅳ组采用100 kV,350 mA,威视派克270 mg I/mL,Ⅲ组使用 FBP 算法,Ⅳ组使用 ASIR 算法,4组病例均使用前瞻性心电门控技术。根据原始图像及最大密度投影(MIP)图像评价冠状动脉各分支的图像质量,分别测量主动脉根部、左冠状动脉(LM)、左前降支(LAD)、回旋支(LCX)、右冠状动脉(RCA)的 CT 值进行比较。比较4组病例中的对比剂碘的用量、噪声、对比噪声比(CNR)、剂量长度乘积(DLP)并计算有效剂量(ED),进行统计学分析。结果优选后的双低组(Ⅳ组)与对照组(Ⅱ组)比较,图像中各支血管 CT 值差异有统计学意义(P <0.05)。双低组 DLP 值、ED 值与对照组比较,2组差异有统计学意义(P <0.05)。结论低电压、低浓度对比剂结合适当的迭代重建技术在冠状动脉 CTA 应用中可满足临床诊断需要,降低 X 线辐射及碘对比剂对患者的危害。
목적：탐토저전압、저농도전대비제재관상동맥 CTA 성상응용과정중강저 X 선복사제량적가행성연구。방법선취CCTA 검사환자80례,분위4조,매조20례：Ⅰ조화Ⅱ조채용120 kV,350 mA,전해순350 mg I/mL,Ⅰ조사용려파반투영중건산법(FBP),Ⅱ조사용자괄응통계질대중건산법(ASIR)；Ⅲ조화Ⅳ조채용100 kV,350 mA,위시파극270 mg I/mL,Ⅲ조사용 FBP 산법,Ⅳ조사용 ASIR 산법,4조병례균사용전첨성심전문공기술。근거원시도상급최대밀도투영(MIP)도상평개관상동맥각분지적도상질량,분별측량주동맥근부、좌관상동맥(LM)、좌전강지(LAD)、회선지(LCX)、우관상동맥(RCA)적 CT 치진행비교。비교4조병례중적대비제전적용량、조성、대비조성비(CNR)、제량장도승적(DLP)병계산유효제량(ED),진행통계학분석。결과우선후적쌍저조(Ⅳ조)여대조조(Ⅱ조)비교,도상중각지혈관 CT 치차이유통계학의의(P <0.05)。쌍저조 DLP 치、ED 치여대조조비교,2조차이유통계학의의(P <0.05)。결론저전압、저농도대비제결합괄당적질대중건기술재관상동맥 CTA 응용중가만족림상진단수요,강저 X 선복사급전대비제대환자적위해。
Objective To investigate the feasibility of X-ray radiation dose reduction in coronary CT angiography (CCTA)by using low-voltage,low concentration of iodine contrast agent.Methods 80 patients underwent CCTA examination,divided into four groups,each 20 cases:Ⅰ group and Ⅱ group with 120 kV,350 mA,iohexol 350 mg/mL,Ⅰ group using filtered back projection re-construction algorithm (FBP),Ⅱ group using adaptive statistical iterative reconstruction algorithm (ASIR);Ⅲ and Ⅳ group using 100 kV,350 mA,Visipaque 270 mg/mL,Ⅲ group using FBP algorithm,Ⅳ group using ASIR algorithm,All the four groups were using prospective ECG gating technology.The image quality of each branch of coronary artery was evaluated based on the original image and the MIP image.CT value of aortic root ,left coronary artery (LM),left anterior descending artery (LAD),circumflex artery (LCX),and right coronary artery (RCA)were measured respectively for comparison.Statistical comparison was made among the four groups regarding the amount of iodine contrast agents ,noise,contrast to noise ratio (CNR),dose-length product (DLP) and the effective dose (ED).Results Preferred dual low group (Ⅳ group )was significantly different from the control group (Ⅱgroup )in terms of the CT value of the coronary branches,DLP,and ED (P <0.05).Conclusion The low-voltage,low concentra-tion of contrast agent combined with appropriate iterative reconstruction technique in coronary CTA is able to meet the needs of the clinical diagnosis,while significantly reducing the health hazards resulting from X-ray radiation and iodinated contrast agent.