CAJ | 학술논문

目的：探讨低电压、低碘对比剂浓度(双低)在冠状动脉 CTA 成像中的可行性。方法76例行冠状动脉 CTA 检查的患者随机分为 A、B 2组,A 组38例为双低组,采用100 kVp 管电压+等渗对比剂威视派克270 mg I/mL+迭代重建技术(ASIR 40%)重建,B 组38例为常规组,采用120 kVp 管电压+低渗对比剂欧乃派克350 mg I/mL+滤波反投影技术(FBP)重建,图像由2名高年资放射科医生进行双盲图像评分。评价主动脉根部(AO)、左主干(LM)、左前降支(LAD)、左回旋支(LCX)及右冠状动脉(RCA)近端的图像质量,包括 CT 值、噪声、信号噪声比(SNR)及对比噪声比(CNR)的测量及计算,并采用 Paired t-test 进行对比分析,记录辐射剂量(CTDIvol,DLP,ED)并用 Paired t-test 进行比较。结果双低组的 CTDIvol,DLP,ED 比常规组分别下降了35.7%,38.6%,38.6%,碘摄入量下降了22.9%,而2组的图像质量没有明显差别,所有病例图像质量都能满足临床需求,A 组在主观评分上要略优于 B 组。结论管电压100 kVp+低碘对比剂浓度270 mg I/mL 完全可以满足诊断需求,而且大幅度降低了辐射剂量和碘摄入量。
목적：탐토저전압、저전대비제농도(쌍저)재관상동맥 CTA 성상중적가행성。방법76례행관상동맥 CTA 검사적환자수궤분위 A、B 2조,A 조38례위쌍저조,채용100 kVp 관전압+등삼대비제위시파극270 mg I/mL+질대중건기술(ASIR 40%)중건,B 조38례위상규조,채용120 kVp 관전압+저삼대비제구내파극350 mg I/mL+려파반투영기술(FBP)중건,도상유2명고년자방사과의생진행쌍맹도상평분。평개주동맥근부(AO)、좌주간(LM)、좌전강지(LAD)、좌회선지(LCX)급우관상동맥(RCA)근단적도상질량,포괄 CT 치、조성、신호조성비(SNR)급대비조성비(CNR)적측량급계산,병채용 Paired t-test 진행대비분석,기록복사제량(CTDIvol,DLP,ED)병용 Paired t-test 진행비교。결과쌍저조적 CTDIvol,DLP,ED 비상규조분별하강료35.7%,38.6%,38.6%,전섭입량하강료22.9%,이2조적도상질량몰유명현차별,소유병례도상질량도능만족림상수구,A 조재주관평분상요략우우 B 조。결론관전압100 kVp+저전대비제농도270 mg I/mL 완전가이만족진단수구,이차대폭도강저료복사제량화전섭입량。
Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.