CAJ | 학술논문

目的评价低浓度对比剂冠状动脉双源CT成像中联合应用低kV和迭代重建技术对于血管强化程度、图像质量和辐射剂量的影响.方法连续收集第四军医大学西京医院放射科2012年1月至2013年1月120例行冠状动脉成像的患者,按先后顺序依照完全随机设计法编号,根据随机表随机分成2组:A组使用碘普罗胺370 mgI/ml,以常规kV扫描,重建图像采用滤过反投影(FBP)法;B组使用碘克沙醇270 mgI/ml,以低kV扫描,重建图像采用正弦确认迭代重建算法(SAFIRE).测量2组冠状动脉主干近段及主动脉、肺动脉、室间隔和左心室的CT值,并比较两组图像的噪声、主观图像质量评分和有效辐射剂量.结果 2组亚组在各相同解剖部位的强化CT值差异均无统计学意义,图像噪声和主观图像质量评分差异也无统计学意义.低浓度组亚组的有效辐射剂量较高浓度组亚组分别降低了53.2％[(0.44±0.25)比(0.94±0.42) mSv,BMI＜23 kg/m2,P ＜0.01]和50.6％[(1.17±0.30)比(2.37 ±0.66) mSv,P＜0.01],差异有统计学意义.结论当联合应用低kV和SAFIRE时,使用低浓度对比剂(270 mgI/ml)进行冠状动脉CT成像,依然可以提高血管的对比强化效果且不降低图像质量,还能极大降低有效辐射剂量.
목적 평개저농도대비제관상동맥쌍원CT성상중연합응용저kV화질대중건기술대우혈관강화정도、도상질량화복사제량적영향.방법 련속수집제사군의대학서경의원방사과2012년1월지2013년1월120례행관상동맥성상적환자,안선후순서의조완전수궤설계법편호,근거수궤표수궤분성2조:A조사용전보라알370 mgI/ml,이상규kV소묘,중건도상채용려과반투영(FBP)법;B조사용전극사순270 mgI/ml,이저kV소묘,중건도상채용정현학인질대중건산법(SAFIRE).측량2조관상동맥주간근단급주동맥、폐동맥、실간격화좌심실적CT치,병비교량조도상적조성、주관도상질량평분화유효복사제량.결과 2조아조재각상동해부부위적강화CT치차이균무통계학의의,도상조성화주관도상질량평분차이야무통계학의의.저농도조아조적유효복사제량교고농도조아조분별강저료53.2％[(0.44±0.25)비(0.94±0.42) mSv,BMI＜23 kg/m2,P ＜0.01]화50.6％[(1.17±0.30)비(2.37 ±0.66) mSv,P＜0.01],차이유통계학의의.결론 당연합응용저kV화SAFIRE시,사용저농도대비제(270 mgI/ml)진행관상동맥CT성상,의연가이제고혈관적대비강화효과차불강저도상질량,환능겁대강저유효복사제량.
Objective To assess the impact of low concentration contrast media on the degree of vascular enhancement,image quality and radiation dose in coronary CT angiography (cCTA) studies when using a combination of iterative reconstruction and low tube voltage.Methods 120 patients who underwent cCTA were randomly divided into two groups.The patients in group A received iopromide 370 were scanned using the conventional tube output,and images were reconstructed using filtered back projection (FBP).The patients in group B received iodixanol 270 were scanned using the low tube output,and images were reconstructed using iterative reconstruction technique (SAFIRE,Siemens Healthcare).CT attenuation was measured in the coronary arteries,great arteries,interventricular septum and left ventricular cavity.Noise,subjective image quality scores and effective radiation dose were compared between the two groups.Results There was no significant difference in the mean CT attenuation achieved,image noise and mean image quality score at each anatomic site between iomeprol 270 group and iopromide 370 group.The effective radiation dose were 0.44 ± 0.25 mSv and 0.94 ± 0.42 mSv for iomeprol 270 and iopromide 370 in low weight subgroups,and 1.17 ±0.30 mSv and 2.37 ±0.66 mSv in high weight subgroups,respectively,reflecting dose savings of 53.2％ (P ＜ 0.01) and 50.6％ (P ＜ 0.01),respectively.Conclusion The results demonstrate that with a combination of iterative reconstruction and a low tube voltage,a low iodine concentration of 270 mgI/ml still improves the contrast enhancement without impairing image quality,as well as significantly lowers effective radiation dose.