CAJ | 학술논문

目的探讨行冠状动脉CT血管成像(CCTA)检查时,低管电压(100 kV)、低碘浓度(270 mgI/ml)对比剂及迭代重建在降低辐射剂量和碘对比剂用量的同时,保持图像质量的可行性.方法连续入选2013年1至5月行CCTA检查的疑诊冠心病患者80例,将患者分为两组:对照组(40例)采用常规方案,即管电压采用120 kV,碘对比剂浓度为370 mgI/ml,采用滤波反投影法重建,重建卷积核为B26f;试验组(40例)管电压采用100kV,碘对比剂浓度为270 mgI/ml,采用迭代重建,重建卷积核为I26f.其他扫描和对比剂注射参数两组间完全一致.对两组的图像进行重建、测量和质量评分,并计算碘用量和有效辐射剂量.结果对照组和试验组患者的体质指数分别为(25.3±3.0) kg/m2和(25.4±3.0) kg/m2(P=0.852),图像信噪比分别为22.2 ±5.5和23.6±5.8(P=0.277),对比度噪声比分别为35.6±17.6和41.1±17.6(P =0.163),图像质量分别为(4.70 ±0.52)分和(4.63±0.59)分(P =0.545).对照组和试验组碘用量分别为(25.27±0.94)g和(18.49±0.75)g(P ＜0.001),试验组较对照组少26.8％.对照组和试验组的有效辐射剂量分别为(3.52±1.16) mSv和(2.31±0.73) mSv(P ＜0.001),试验组较对照组少34.4％.结论行CCTA检查时,采用低管电压、低碘浓度对比剂和迭代重建可以在保持冠状动脉图像质量不降低的基础上,显著减少碘对比剂用量及有效辐射剂量.
목적 탐토행관상동맥CT혈관성상(CCTA)검사시,저관전압(100 kV)、저전농도(270 mgI/ml)대비제급질대중건재강저복사제량화전대비제용량적동시,보지도상질량적가행성.방법 련속입선2013년1지5월행CCTA검사적의진관심병환자80례,장환자분위량조:대조조(40례)채용상규방안,즉관전압채용120 kV,전대비제농도위370 mgI/ml,채용려파반투영법중건,중건권적핵위B26f;시험조(40례)관전압채용100kV,전대비제농도위270 mgI/ml,채용질대중건,중건권적핵위I26f.기타소묘화대비제주사삼수량조간완전일치.대량조적도상진행중건、측량화질량평분,병계산전용량화유효복사제량.결과 대조조화시험조환자적체질지수분별위(25.3±3.0) kg/m2화(25.4±3.0) kg/m2(P=0.852),도상신조비분별위22.2 ±5.5화23.6±5.8(P=0.277),대비도조성비분별위35.6±17.6화41.1±17.6(P =0.163),도상질량분별위(4.70 ±0.52)분화(4.63±0.59)분(P =0.545).대조조화시험조전용량분별위(25.27±0.94)g화(18.49±0.75)g(P ＜0.001),시험조교대조조소26.8％.대조조화시험조적유효복사제량분별위(3.52±1.16) mSv화(2.31±0.73) mSv(P ＜0.001),시험조교대조조소34.4％.결론 행CCTA검사시,채용저관전압、저전농도대비제화질대중건가이재보지관상동맥도상질량불강저적기출상,현저감소전대비제용량급유효복사제량.
Objective To investigate the feasibility of using lower iodine concentration 270 mgI/ml) contrast medium,lower X-ray tube voltage (100 kVp) and iterative reconstruction (IR) to reduce both iodine load and radiation dose but keep the image quality of coronary CT angiography (CCTA).Methods A total of 80 consecutive patients with suspected coronary artery disease were prospectively assigned to one of two groups via computer central system from January to May 2013.The control group (n =40) was scanned using dual-source CCTA protocols of 120 kV,370 mgI/ml Iopromide and filtered back projection reconstruction with a vascular algorithm (B26f).The study group (n =40) was scanned using 100 kV,270 mgI/ml Iodixanol and sinogram affirmed iterative reconstruction with a vascular algorithm (I26f).Other scan parameters and contrast injection protocol were similar between the two groups.Attenuation in the ascending aorta and coronary arteries along with image noise were measured.Images were reconstructed,measured and graded,and iodine load and effective radiation dose were calculated.Results The body mass index ((25.3 ± 3.0) kg/m2 vs.(25.4 ± 3.0) kg/m2,P =0.852),image quality scores (4.70 ±0.52 vs.4.63 ±0.59,P =0.545),mean signal-to-noise ratios (22.2 ±5.5 vs.23.6 ± 5.8,P =0.277),and contrast-to-noise ratios (35.6 ± 17.6 vs.41.1 ± 17.6,P =0.163) were similar between the control group and study group.Mean iodine loads were significantly reduced in the study group ((18.49 ± 0.75) g) compared to control group ((25.27 ± 0.94) g),P ＜ 0.001).Mean effective radiation doses were also significantly reduced in the study group ((2.31 ± 0.73) mSv) compared to that in control group ((3.52 ± 1.16) mSv),P ＜ 0.001).Conclusion Use of low X-ray tube voltage and iterative reconstruction allows lower iodine load and effective radiation dose application at CCTA without image quality reduction.