CAJ | 학술논문

目的：探讨双源 CT(DSCT)低管电压、低对比剂浓度(双低)成像技术在低体重患者中应用的可行性。方法60例临床需要行 CT 冠状动脉成像(CCTA)的低体重患者(BMI≤25 kg/m2)随机分为2组：A 组为双低组(n=30,管电压80 kV),采用迭代重建(SAFIRE)技术及270 mg I/mL 浓度对比剂增强；B 组为常规组(n =30,管电压120 kV),采用滤波反投影(FBP)技术及350 mg I/mL 浓度对比剂增强。2组均使用自适应前瞻性心电门控序列扫描(CorAdSeq)技术,采集时相为65%~75%R-R 间期(心率<75次/min)或40%~50%R-R 间期(心率≥75次/min)。图像质量采用主观法和客观法进行评价,以常规组为对照,分析“双低”组的图像质量和辐射剂量。应用 SPSS 19.0软件进行统计学分析,采用独立样本 t 检验评价各计量资料间的差异,以 P <0.05为差异有统计学意义。结果A 组(1.22±0.31)mGy/cm 的 EDssde 较 B 组(3.44±0.80)mGy/cm 明显降低,2组差异有统计学意义(P <0.001)。A、B 2组的噪声差异无统计学意义(P >0.05,表3),A 组与 B 组的平均 CNR、平均 SNR 及平均 CT 值差别有统计学意义(P <0.05),A 组高于 B 组。结论与常规 DSCT 冠状动脉成像方案相比,对于低体重患者(BMI≤25 kg/m2),“双低”DSCT 冠状动脉扫描方案所获得的冠状动脉图像能够满足临床诊断需要,并且可以大幅降低辐射剂量及对比剂使用量。
목적：탐토쌍원 CT(DSCT)저관전압、저대비제농도(쌍저)성상기술재저체중환자중응용적가행성。방법60례림상수요행 CT 관상동맥성상(CCTA)적저체중환자(BMI≤25 kg/m2)수궤분위2조：A 조위쌍저조(n=30,관전압80 kV),채용질대중건(SAFIRE)기술급270 mg I/mL 농도대비제증강；B 조위상규조(n =30,관전압120 kV),채용려파반투영(FBP)기술급350 mg I/mL 농도대비제증강。2조균사용자괄응전첨성심전문공서렬소묘(CorAdSeq)기술,채집시상위65%~75%R-R 간기(심솔<75차/min)혹40%~50%R-R 간기(심솔≥75차/min)。도상질량채용주관법화객관법진행평개,이상규조위대조,분석“쌍저”조적도상질량화복사제량。응용 SPSS 19.0연건진행통계학분석,채용독립양본 t 검험평개각계량자료간적차이,이 P <0.05위차이유통계학의의。결과A 조(1.22±0.31)mGy/cm 적 EDssde 교 B 조(3.44±0.80)mGy/cm 명현강저,2조차이유통계학의의(P <0.001)。A、B 2조적조성차이무통계학의의(P >0.05,표3),A 조여 B 조적평균 CNR、평균 SNR 급평균 CT 치차별유통계학의의(P <0.05),A 조고우 B 조。결론여상규 DSCT 관상동맥성상방안상비,대우저체중환자(BMI≤25 kg/m2),“쌍저”DSCT 관상동맥소묘방안소획득적관상동맥도상능구만족림상진단수요,병차가이대폭강저복사제량급대비제사용량。
Objective To explore the feasibility of “double low ”(low tube voltage and low contrast agent concentration)imaging technology of dual-source computed tomography (DSCT)in coronary angiography for low-weight patients.Methods 60 patients (BMI≤25 kg/m2 )who underwent coronary CT angiography (CCTA)on DSCT scanner were divided randomly into 2 groups:group A was “double low”group (n = 30,tube voltage = 80 kVp,using sinogram affirmed iterative reconstruction technology and 270 mg I/mL concentration of contrast agent);Group B was conventional group (n=30,tube voltage=120 kVp,using filtered back projection technology and 350 mg I/mL concentration of contrast agent).Adaptive cardiosequence prospective ECG-gated technology (CorAdSeq)was applied in both the groups,The collecting phase was 65%-75% RR interval (when heart rate<70 beats per mi-nute)or 40%-50% RR interval (when heart rate≥70 beats per minute).Subjective and objective methods were applied to evaluate the image quality.The image quality and.radiation dose were compared between the “double low”group and the conventional group by using SPSS 1 9.0 software.The differences between measurement data were analyzed by using independent samples t-test.Results The effective dose with size specific dose estimates (EDssde)of group A(1.22±0.31)mGy/cm was significantly lower than that of group B (3.44±0.80)mGy/cm with P <0.001.Contrast-noise ratio,signal-noise ratio and CT value of group A were signifi-cantly higher than those of group B (all P <0.05 ).Conclusion Compared with conventional DSCT coronary angiography,“double low”DSCT coronary scanning proposal for low-weight patients can significantly reduce the radiation dose and the amount of contrast agent,and the image quality can meet the needs of clinical diagnosis.