CAJ | 학술논문

目的探讨智能最佳管电压扫描技术在双源CT冠状动脉CT血管成像(CTA)中的应用价值.方法收集临床拟诊为冠心病需要行冠状动脉CTA检查且体质量指数(BMI) ＜25 kg/m2的150例患者,依据扫描方法的不同采用简单随机化法分为5组,每组30例行冠状动脉CTA检查.A、B、C三组智能最佳管电压扫描技术设置为半自动,管电压分别为120、100、80kV(参考电压为120 kV,参考电流为400 mAs);D、E组智能最佳管电压扫描技术设置为开启,D组参考管电压120 kV,参考管电流400 mAs;E组参考管电压100 kV、参考管电流400 mAs.对管腔直径＞2 mm且无严重钙化的冠状动脉行改良15段分段法评价,进行主观评价(图像质量评分)和客观评价(包括血管CT值、噪声、信噪比和对比噪声比),并记录辐射剂量.采用单因素方差分析比较各组患者的图像质量、图像客观评价指标和辐射剂量的差异.结果 A、B、C、D和E组的图像质量评分分别为(3.42±0.63)、(3.41±0.54)、(3.49±0.33)、(3.45±0.43)和(3.48±0.81)分,差异无统计学意义(F=0.634,P=0.105).各组图像质量均较好,均能清晰显示血管全程.上述各组的冠状动脉CT值分别为(486±82)、(554±71)、(742±90)、(506±81)、(561±81)HU,图像噪声分别为(25±12)、(32±12)、(46±14)、(28±11)、(34±12)HU,差异均有统计学意义(F值分别为3.430和4.332,P均＜0.05).各组的SNR、CNR差异均无统计学意义(P均＞0.05).上述5组的有效辐射剂量分别为(9.3±1.3)、(6.3±1.4)、(2.8±1.5)、(5.7±1.2)、(3.9±1.3)mSv,差异有统计学意义(F=2.332,P＜0.05).结论对于BMI处于正常标准的患者,采用开启智能最佳管电压扫描技术(参考管电压100 kV,参考管电流400 mAs)行冠状动脉CTA检查,在保证图像质量的同时,可以有效地降低辐射剂量.
목적 탐토지능최가관전압소묘기술재쌍원CT관상동맥CT혈관성상(CTA)중적응용개치.방법 수집림상의진위관심병수요행관상동맥CTA검사차체질량지수(BMI) ＜25 kg/m2적150례환자,의거소묘방법적불동채용간단수궤화법분위5조,매조30례행관상동맥CTA검사.A、B、C삼조지능최가관전압소묘기술설치위반자동,관전압분별위120、100、80kV(삼고전압위120 kV,삼고전류위400 mAs);D、E조지능최가관전압소묘기술설치위개계,D조삼고관전압120 kV,삼고관전류400 mAs;E조삼고관전압100 kV、삼고관전류400 mAs.대관강직경＞2 mm차무엄중개화적관상동맥행개량15단분단법평개,진행주관평개(도상질량평분)화객관평개(포괄혈관CT치、조성、신조비화대비조성비),병기록복사제량.채용단인소방차분석비교각조환자적도상질량、도상객관평개지표화복사제량적차이.결과 A、B、C、D화E조적도상질량평분분별위(3.42±0.63)、(3.41±0.54)、(3.49±0.33)、(3.45±0.43)화(3.48±0.81)분,차이무통계학의의(F=0.634,P=0.105).각조도상질량균교호,균능청석현시혈관전정.상술각조적관상동맥CT치분별위(486±82)、(554±71)、(742±90)、(506±81)、(561±81)HU,도상조성분별위(25±12)、(32±12)、(46±14)、(28±11)、(34±12)HU,차이균유통계학의의(F치분별위3.430화4.332,P균＜0.05).각조적SNR、CNR차이균무통계학의의(P균＞0.05).상술5조적유효복사제량분별위(9.3±1.3)、(6.3±1.4)、(2.8±1.5)、(5.7±1.2)、(3.9±1.3)mSv,차이유통계학의의(F=2.332,P＜0.05).결론 대우BMI처우정상표준적환자,채용개계지능최가관전압소묘기술(삼고관전압100 kV,삼고관전류400 mAs)행관상동맥CTA검사,재보증도상질량적동시,가이유효지강저복사제량.
Objective To explore the value of intelligent optimum tube voltage technology at dual-source CT coronary angiography.Methods One hundred and fifty patients with normal body mass index (＜25 kg/m2) with clinically suspected coronary heart disease requiring coronary artery CTA examination were collected.According to the different scanning method,patients were randomly divided into 5 groups,30 cases of each group were tested by coronary artery CTA examination.The intelligent optimum tube vohage scanning technology was set to "Semi",the tube voltage of A,B,C group were 120,100 and 80 kV (Ref 120 kV,400 mAs),respectively.D and E group were set to "on",the reference voltage of group D was 120 kV,and reference current was 400 mAs.The reference voltage of group E was 100 kV,reference current was 400 mAs.Using the 15 section improved segment method for evaluation of coronary artery (lumen diameter＞ 2 mm and no severe calcification).They were assessed by subjective evaluation (image quality score) and objective evaluation (including vascular CT value,signal-to-noise ratio and contrast to noise ratio).Analyses of the differences between groups were compared with image quality,objective evaluation index and radiation dose by single factor variance.Results The image quality scores in patients scanned with five groups were (3.42±0.63),(3.41±0.54),(3.49±0.33),(3.45±0.43) and (3.48±0.81),there was no statistical difference between the five groups (F=0.634,P=0.105).Each image quality was good,all could clearly show thewhole range of vessels.The CT values of the coronary artery with above groups respectively were (486±82),(554±71),(742±90),(506±81),(561±81) HU.The image noises were (25±12),(32±12),(46±14),(28± 11),(34±12) HU (F=3.430 and 4.332,P＜0.05).And the SNR and CNR was no statistic difference between the five groups (P＞0.05).The effective radiation dose of five groups are (9.3± 1.3),(6.3± 1.4),(2.8±1.5),(5.7 ± 1.2),(3.9 ± 1.3) mSv,which the difference was statistically significant (F=2.332,P＜0.05).Conclusions Intelligent optimum tube voltage technology (Ref.100 kV,400 mAs) at dual-source CT coronary angiography may be feasible in patients with normal BMI.To ensure the quality of the image at the same time,it can effectively reduce the radiation dose.