CAJ | 학술논문

目的：双能量冠状动脉 CT 血管成像（CTA）是一种非常具有前景的一站式检查，但较高的辐射剂量使其应用受到限制，本文拟探讨低管电流结合基于原始数据的迭代重建（SAFIRE）技术双能量冠状动脉 CTA 低剂量检查的可行性。资料与方法120例检查者根据 A 球管电流随机分为常规180 mAs、滤波反投影重建组及低剂量150 mAs、120 mAs、90 mAs 组，每组30例，低剂量组采用 SAFIRE 3重建，比较4组平均 CT 值、图像噪声（SD）、信噪比（SNR）、对比噪声比（CNR）、图像质量主观评分及辐射剂量（ED）。结果4组病例冠状动脉显示节段、平均 CT 值差异无统计学意义（P>0.05），图像质量主观评分、SD、SNR、CNR 差异有统计学意义（P<0.05），其中150 mAs 组图像质量主观评分、SNR、CNR 最高，SD 最低；但常规180 mAs 组与90 mAs 组图像质量主观评分、SD、SNR、CNR 差异无统计学意义（P>0.05）；4组 ED 分别为（5.50±1.47）mSv、（4.55±1.16）mSv、（3.41±0.77）mSv、（2.44±0.67）mSv（P<0.05），90 mAs 组较180 mAs 组 ED 下降了55.62%。结论90 mAs 结合 SAFIRE 行双能量冠状动脉 CTA 检查能够保证图像质量，并大幅降低辐射剂量，具有较好的应用前景。
목적：쌍능량관상동맥 CT 혈관성상（CTA）시일충비상구유전경적일참식검사，단교고적복사제량사기응용수도한제，본문의탐토저관전류결합기우원시수거적질대중건（SAFIRE）기술쌍능량관상동맥 CTA 저제량검사적가행성。자료여방법120례검사자근거 A 구관전류수궤분위상규180 mAs、려파반투영중건조급저제량150 mAs、120 mAs、90 mAs 조，매조30례，저제량조채용 SAFIRE 3중건，비교4조평균 CT 치、도상조성（SD）、신조비（SNR）、대비조성비（CNR）、도상질량주관평분급복사제량（ED）。결과4조병례관상동맥현시절단、평균 CT 치차이무통계학의의（P>0.05），도상질량주관평분、SD、SNR、CNR 차이유통계학의의（P<0.05），기중150 mAs 조도상질량주관평분、SNR、CNR 최고，SD 최저；단상규180 mAs 조여90 mAs 조도상질량주관평분、SD、SNR、CNR 차이무통계학의의（P>0.05）；4조 ED 분별위（5.50±1.47）mSv、（4.55±1.16）mSv、（3.41±0.77）mSv、（2.44±0.67）mSv（P<0.05），90 mAs 조교180 mAs 조 ED 하강료55.62%。결론90 mAs 결합 SAFIRE 행쌍능량관상동맥 CTA 검사능구보증도상질량，병대폭강저복사제량，구유교호적응용전경。
Purpose Dual-energy coronary artery CT angiography (CTA) is a very promising one-stop examine, but the radiation dose is too high to hinder the development of the technology. The aim of this article is to explore the feasibility of low tube current combined with sonogram-affirmed iterative reconstruction (SAFIRE) technology in dual energy coronary artery CTA scan. Materials and Methods One hundred and twenty patients were randomly divided into four groups according to the tube current of A ball:conventional group (180 mAs) and low-dose groups (150 mAs, 120 mAs, 90 mAs). The SAFIRE 3 reconstruction method was used in the low-dose groups. The differences of mean CT values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality score and effective dose (ED) of the four groups were compared. Results The coronary artery segment display and the mean CT value of the four groups showed no statistic difference (P>0.05), while the image quality score, noise, SNR, and CNR showed statistic difference (P<0.05). The image quality score, SNR, and CNR was highest in the 150 mAs group, but noise was the lowest. There were no statistic difference of the image quality score, SNR, and CNR between the 180 mAs group and 90 mAs group (P>0.05). The ED was (5.50±1.47) mSv, (4.55±1.16) mSv, (3.41±0.77) mSv and (2.44±0.67) mSv, respectively for the four groups, and there was statistical difference (P<0.05). ED of 90 mAs group decreased 55.62% than that of 180 mAs group. Conclusion Coronary artery CTA using 90 mAs combined with SAFIRE can significantly reduce the radiation dose without losing image quality, thus it has a good prospect of clinical application.