CAJ | 학술논문

目的定量及定性评价不同管电压及不同对比剂剂量条件下CT冠状动脉图像质量,优选CT冠状动脉成像的扫描方案.方法选取徐州医学院附属医院2013年1至5月45例临床怀疑冠心病的患者,随机分为A、B、C3组,每组15例,A组采用管电压120 kVp、浓度350 mgI/ml的对比剂;B组采用管电压100 kVp、浓度350 mgI/ml的对比剂;C组采用管电压100 kVp、浓度270 mgI/ml的对比剂.对3组患者行CT冠状动脉成像,分别测量3组中冠状动脉右冠状动脉(RCA),左冠状动脉前降支(LAD),左冠状动脉回旋支(CX)的CT值,比较3组的信噪比(SNR)、对比噪声比(CNR)、有效辐射剂量(ED)、碘摄取量,分析2名阅片者比较3组不同扫描方案下冠状动脉图像质量的一致性.结果 3组冠状动脉CT成像图像质量差异均无统计学意义(均P＞0.05),2名医师的评价结果经kappa检验,两名读片者的一致性好(k=0.754,P＜0.05).RCA、LAD、CX在A、B、C3组不同扫描方案下,B组CT值最高,RCA、LAD、CX的CT值分别为(537 ±90),(505±90),(484±75) HU.C组CT值最低,RCA、LAD、CX的CT值分别为(357±126),(360±95),(378±121) HU,3组CT值差异均有统计学意义(均P ＜0.05).3组间SNR值及CNR值差异均无统计学意义(均P＞0.05),3组间ED值差异均有统计学意义(均P＜0.05),C组碘摄取量比A、B组降低了23％.结论 100 kVp(270 mgI/ml)冠状动脉CT成像扫描方案可达到120 kVp(350 mgI/ml)、100 kVp(350 mgI/ml)扫描方案的客观和主观的图像质量,在降低扫描的辐射剂量的同时减少了对比剂剂量的使用.
목적 정량급정성평개불동관전압급불동대비제제량조건하CT관상동맥도상질량,우선CT관상동맥성상적소묘방안.방법 선취서주의학원부속의원2013년1지5월45례림상부의관심병적환자,수궤분위A、B、C3조,매조15례,A조채용관전압120 kVp、농도350 mgI/ml적대비제;B조채용관전압100 kVp、농도350 mgI/ml적대비제;C조채용관전압100 kVp、농도270 mgI/ml적대비제.대3조환자행CT관상동맥성상,분별측량3조중관상동맥우관상동맥(RCA),좌관상동맥전강지(LAD),좌관상동맥회선지(CX)적CT치,비교3조적신조비(SNR)、대비조성비(CNR)、유효복사제량(ED)、전섭취량,분석2명열편자비교3조불동소묘방안하관상동맥도상질량적일치성.결과 3조관상동맥CT성상도상질량차이균무통계학의의(균P＞0.05),2명의사적평개결과경kappa검험,량명독편자적일치성호(k=0.754,P＜0.05).RCA、LAD、CX재A、B、C3조불동소묘방안하,B조CT치최고,RCA、LAD、CX적CT치분별위(537 ±90),(505±90),(484±75) HU.C조CT치최저,RCA、LAD、CX적CT치분별위(357±126),(360±95),(378±121) HU,3조CT치차이균유통계학의의(균P ＜0.05).3조간SNR치급CNR치차이균무통계학의의(균P＞0.05),3조간ED치차이균유통계학의의(균P＜0.05),C조전섭취량비A、B조강저료23％.결론 100 kVp(270 mgI/ml)관상동맥CT성상소묘방안가체도120 kVp(350 mgI/ml)、100 kVp(350 mgI/ml)소묘방안적객관화주관적도상질량,재강저소묘적복사제량적동시감소료대비제제량적사용.
Objective To evaluate image quality of low-voltage coronary artery computed tomographic (CT) angiography with low contrast agent in comparison with image quality.Methods Forty-five patients underwent coronary artery computed tomographic (CT) angiography.They were randomly assigned to 3 groups,group A(n =15)were scanned in 120 kVp with 350 mgI/ml iodinated contrast agent mode,group B(n =15)were scanned in 100 kVp with 350 mgI/ml iodinated contrast agent mode,group C (n =15) were scanned in 100 kVp with 270 mgI/ml iodinated contrast agent mode.Then measured CT attenuation value of three main branches (RCA,LAD and CX) of coronary artery,And compare the SNR,CNR,the effective radiation dose(ED) and iodine intake.The Kappa test were used to quantify inter-and intra-reader agreement in detecting quality of the images under different scanning solutions.Results Three groups of coronary artery CT image quality was no statistically significant differences (all P values ＞ 0.05),Good inter-and intra-reader agreement (k =0.754,P ＜ 0.05) for the detection of noise in all the patients.There was significant difference in the CT attenuation of RCA,LAD and CX among the 3 groups (P ＜ 0.05),the CT attenuation was the highest in group B,the CT value of RCA,LAD and CX were 537 ± 90,505±90,484 ± 75 HU,respectively.the CT attenuation was the lowest in group C,the CT value of RCA,LAD and CX were 357 ± 126,360 ± 95,378 ± 121 HU,respectively.There was no significant difference in the SNR and CNR among the 3 groups (P ＞ 0.05).There was significant difference in the ED among the 3 groups (P ＜ 0.05).The ED value of the group A was bigger than the value of the group B and C.There was no significant difference between the group B and C.Compared the group A and B,the iodine intake of the group C had fallen by 23％.Conclusions The coronary artery CT angiography using 100 kVp with 270 mgI/ml iodinated contrast agent provide similar objective or subjective image quality compared with the (350 mgI/ml)and the 100 kVp(350 mgI/ml),thus enabling effective dose and iodine intake reduction without loss of diagnostic information.