中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2015年
3期
226-230
,共5页
葛尚%李春和%潘昌杰%王涛%徐烈福
葛尚%李春和%潘昌傑%王濤%徐烈福
갈상%리춘화%반창걸%왕도%서렬복
辐射剂量%体层摄影术%冠状动脉%迭代重建%对比剂
輻射劑量%體層攝影術%冠狀動脈%迭代重建%對比劑
복사제량%체층섭영술%관상동맥%질대중건%대비제
Radiation dose%Tomography%Coronary artery%Iterative reconstruction%Contrast agent
目的 探讨双源CT低管电压、低对比剂浓度(双低)冠状动脉CT成像检查(coronary artery CT angiography,CCTA)的图像质量和辐射剂量.方法 160例疑有冠状动脉疾病的患者行CCTA检查,将80例BMI＜ 25 kg/m2的患者按随机数字表法分成270 mg I/ml-80 kV组(A组)、350 mg I/ml-120 kV组(B组),另80例25≤BMI＜ 30 kg/m2的患者按同样方法分成270 mg I/ml-100kV组(C组)、350 mg I/ml-120 kV组(D组),每组40例.A、C两组采用迭代重建技术及270 mg I/ml的碘克沙醇,B、D两组采用滤波反投影技术及350 mg I/ml的碘海醇.各组均使用自适应前瞻性心电门控序列扫描技术,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).对每位患者的CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(E)、体型特异性剂量评估(SSDE)、图像噪声、冠状动脉CT值、信噪比(SNR)和对比噪声比(CNR)进行评估.结果 A、B组与C、D组间扫描长度差异无统计学意义.A、B组间管电流差异有统计学意义(t=8.932,P＜0.05),C、D组间管电流差异无统计学意义(P＞0.05).A、B组与C、D组间CTDIvol、DLP、E和SSDE差异均有统计学意义(tCTDIvol=-16.141,-11.440;tDLP=-17.454,-10.521;tE=-17.444,-10.523;tSSDE=-13.032,-9.119,P＜0.05).与B组相比,A组SSDE下降了64.4％;与D组相比,C组SSDE下降了39.3％.A、B组与C、D组间噪声平均值差异无统计学意义(P＞0.05).A、B组间冠状动脉的平均CT值、平均SNR及平均CNR差异有统计学意义(T=0.436,4.623,3.272,P＜0.05);C、D组间冠状动脉的平均CT值、平均CNR差异无统计学意义(P＞0.05),平均SNR差异有统计学意义(t=2.981,P＜0.05).A、B组与C、D组间主观图像质量评分比较,差异无统计学意义(P＞0.05).结论 与常规双源CT冠状动脉成像方案相比,“双低”扫描方案可以大幅降低辐射剂量及对比剂使用量,并且所获得的冠状动脉图像仍能满足临床诊断需要.
目的 探討雙源CT低管電壓、低對比劑濃度(雙低)冠狀動脈CT成像檢查(coronary artery CT angiography,CCTA)的圖像質量和輻射劑量.方法 160例疑有冠狀動脈疾病的患者行CCTA檢查,將80例BMI＜ 25 kg/m2的患者按隨機數字錶法分成270 mg I/ml-80 kV組(A組)、350 mg I/ml-120 kV組(B組),另80例25≤BMI＜ 30 kg/m2的患者按同樣方法分成270 mg I/ml-100kV組(C組)、350 mg I/ml-120 kV組(D組),每組40例.A、C兩組採用迭代重建技術及270 mg I/ml的碘剋沙醇,B、D兩組採用濾波反投影技術及350 mg I/ml的碘海醇.各組均使用自適應前瞻性心電門控序列掃描技術,採集時相為65％ ～75％ R-R間期(心率＜75次/min)或40％～ 50％ R-R間期(心率≥75次/min).對每位患者的CT容積劑量指數(CTDIvol)、劑量長度乘積(DLP)、有效輻射劑量(E)、體型特異性劑量評估(SSDE)、圖像譟聲、冠狀動脈CT值、信譟比(SNR)和對比譟聲比(CNR)進行評估.結果 A、B組與C、D組間掃描長度差異無統計學意義.A、B組間管電流差異有統計學意義(t=8.932,P＜0.05),C、D組間管電流差異無統計學意義(P＞0.05).A、B組與C、D組間CTDIvol、DLP、E和SSDE差異均有統計學意義(tCTDIvol=-16.141,-11.440;tDLP=-17.454,-10.521;tE=-17.444,-10.523;tSSDE=-13.032,-9.119,P＜0.05).與B組相比,A組SSDE下降瞭64.4％;與D組相比,C組SSDE下降瞭39.3％.A、B組與C、D組間譟聲平均值差異無統計學意義(P＞0.05).A、B組間冠狀動脈的平均CT值、平均SNR及平均CNR差異有統計學意義(T=0.436,4.623,3.272,P＜0.05);C、D組間冠狀動脈的平均CT值、平均CNR差異無統計學意義(P＞0.05),平均SNR差異有統計學意義(t=2.981,P＜0.05).A、B組與C、D組間主觀圖像質量評分比較,差異無統計學意義(P＞0.05).結論 與常規雙源CT冠狀動脈成像方案相比,“雙低”掃描方案可以大幅降低輻射劑量及對比劑使用量,併且所穫得的冠狀動脈圖像仍能滿足臨床診斷需要.
목적 탐토쌍원CT저관전압、저대비제농도(쌍저)관상동맥CT성상검사(coronary artery CT angiography,CCTA)적도상질량화복사제량.방법 160례의유관상동맥질병적환자행CCTA검사,장80례BMI＜ 25 kg/m2적환자안수궤수자표법분성270 mg I/ml-80 kV조(A조)、350 mg I/ml-120 kV조(B조),령80례25≤BMI＜ 30 kg/m2적환자안동양방법분성270 mg I/ml-100kV조(C조)、350 mg I/ml-120 kV조(D조),매조40례.A、C량조채용질대중건기술급270 mg I/ml적전극사순,B、D량조채용려파반투영기술급350 mg I/ml적전해순.각조균사용자괄응전첨성심전문공서렬소묘기술,채집시상위65％ ～75％ R-R간기(심솔＜75차/min)혹40％～ 50％ R-R간기(심솔≥75차/min).대매위환자적CT용적제량지수(CTDIvol)、제량장도승적(DLP)、유효복사제량(E)、체형특이성제량평고(SSDE)、도상조성、관상동맥CT치、신조비(SNR)화대비조성비(CNR)진행평고.결과 A、B조여C、D조간소묘장도차이무통계학의의.A、B조간관전류차이유통계학의의(t=8.932,P＜0.05),C、D조간관전류차이무통계학의의(P＞0.05).A、B조여C、D조간CTDIvol、DLP、E화SSDE차이균유통계학의의(tCTDIvol=-16.141,-11.440;tDLP=-17.454,-10.521;tE=-17.444,-10.523;tSSDE=-13.032,-9.119,P＜0.05).여B조상비,A조SSDE하강료64.4％;여D조상비,C조SSDE하강료39.3％.A、B조여C、D조간조성평균치차이무통계학의의(P＞0.05).A、B조간관상동맥적평균CT치、평균SNR급평균CNR차이유통계학의의(T=0.436,4.623,3.272,P＜0.05);C、D조간관상동맥적평균CT치、평균CNR차이무통계학의의(P＞0.05),평균SNR차이유통계학의의(t=2.981,P＜0.05).A、B조여C、D조간주관도상질량평분비교,차이무통계학의의(P＞0.05).결론 여상규쌍원CT관상동맥성상방안상비,“쌍저”소묘방안가이대폭강저복사제량급대비제사용량,병차소획득적관상동맥도상잉능만족림상진단수요.
Objective To explore the image quality and radiation dose for coronary angiography using DSCT (dual-source computed tomography) under lower tube voltage and lower contrast agent concentration ('double low').Methods A total of 160 patients with suspected coronary artery disease underwent dual-source CCTA.80 patients (BMI ＜ 25 kg/m2) were randomly assigned to group A (270 mg I/ml-80 kV) and B (350 mg I/ml-120 kV).The other 80 patients (25 ≤ BMI ＜30 kg/m2) were randomly assigned to group C (270 mg I/ml-100 kV) and D (350 mg I/ml-120 kV),sonogram affirmed iterative reconstruction technology and 270 mg I/ml contrast agent were applied to group A and C ; FBP technology and 350 mg I/ml contrast agent were applied to group B and D.Adaptive cardio-sequence prospective ECG-gated technology was applied in all patients,while the acquisition phase was 65％-75％ RR interval (when heart rate ＜ 75 beats / min) or 40％-50％ RR interval at when heart rate ≥ 75 beats/min.Volume CT dose index (CTDIvol),dose length product (DLP),effective dose (E),size specific dose estimates (SSDE),image noise,CT value,signal-to-noise ratio (SNR),and contrast-to-noise ratio(CNR) were all evaluated for each patient.Results There was not statistical difference in scan length among groups A and B,C and D.There was statistical difference in tube current between group A and B (t =8.932,P ＜0.05).There was not statistical difference in tube current between group C and D (tCD =-1.212,P ＞ 0.05).There was statistical difference in CTDIvol,DLP,E and SSDE between group A and B,C and D (tCTDIvol =-16.141,-11.440 ; tDLP =-17.454,-10.521 ; t =-17.444,-10.523 ;tSSDE =-13.032,-9.119,P ＜0.05).Compared to group B,the SSDE in group A decreased by 64.4％.Compared to group D,the SSDE in group C decreased by 39.3％.There was no statistical difference in image noise between group A and B,C and D (P ＞ 0.05).There was statistical difference in CT value,SNR and CNR between group A and B (t =0.436,4.623,3.272,P ＜ 0.05).There was no statistical difference in CT value and CNR between group C and D,while there was statistical difference in SNR between group C and D (t =2.981,P ＜0.05).There was no statistical difference in image quality scores between group A and B,C and D (P ＞ 0.05).Conclusion Compared with conventional DSCT coronary angiography,'double low' DSCT coronary scanning solution can significantly reduce the radiation dose and contrast agent,and could provide the effective coronary images which meet the clinical diagnostic needs.
