河北医药
河北醫藥
하북의약
HEBEI MEDICAL JOURNAL
2015年
16期
2418-2421
,共4页
朱红伟%王素娟%王晔%马士华
硃紅偉%王素娟%王曄%馬士華
주홍위%왕소연%왕엽%마사화
对比剂%超重%肥胖%体重指数%体层摄影术,X线计算机%辐射剂量
對比劑%超重%肥胖%體重指數%體層攝影術,X線計算機%輻射劑量
대비제%초중%비반%체중지수%체층섭영술,X선계산궤%복사제량
contrast media%overweight,obesity%BMI%tomography,X-ray computed%radiation dosage
目的：初步探讨通过降低kV降低超重和肥胖人群冠状动脉CTA辐射剂量的可行性。方法连续收集超重患者60例、肥胖患者72例，每组均分成低剂量组和常规剂量组，分别记作A1和A2、B1和B2组， A1组采用100 kV、A2和B1组120 kV、B2组采用140 kV，对比剂选用碘海醇（350 mg／ml）进行增扫描。对冠状动脉9个主要节段图像进行主观评分，对右冠状动脉近段（RCA-p）、左主干LM（LMA）、左前降支近段（LAD-p）、左回旋支近段（LCX-p）4个主要节段管腔增强后CT值及SD和同水平前胸壁肌肉组织的CT值及SD进行记录。对A1和A2、B1和B2以上增强水平、图像评分、图像噪声、信噪比（ SNR）、噪声比（ CNR）、有效辐射剂量（ ED）等进行分析比较。结果所有纳入病例均完成冠脉检查，图像质量满足诊断要求。9个冠脉节段图像评分、4个冠脉节段增强水平、图像噪声、SNR差异无明显统计学意义， CNR、ED差异具有统计学意义。 A1组和A2组ED 分别为（8ó．47±0．76） mSv和（12．22±2．41）mSv，B1和B2组ED分别为（13．69±1．142）mSv和（20．31±1．36） mSv。结论对于超重和肥胖人群进行冠脉检查，可通过降低kV减少检查个体的有效辐射剂量，降低冠脉图像CNR。
目的：初步探討通過降低kV降低超重和肥胖人群冠狀動脈CTA輻射劑量的可行性。方法連續收集超重患者60例、肥胖患者72例，每組均分成低劑量組和常規劑量組，分彆記作A1和A2、B1和B2組， A1組採用100 kV、A2和B1組120 kV、B2組採用140 kV，對比劑選用碘海醇（350 mg／ml）進行增掃描。對冠狀動脈9箇主要節段圖像進行主觀評分，對右冠狀動脈近段（RCA-p）、左主榦LM（LMA）、左前降支近段（LAD-p）、左迴鏇支近段（LCX-p）4箇主要節段管腔增彊後CT值及SD和同水平前胸壁肌肉組織的CT值及SD進行記錄。對A1和A2、B1和B2以上增彊水平、圖像評分、圖像譟聲、信譟比（ SNR）、譟聲比（ CNR）、有效輻射劑量（ ED）等進行分析比較。結果所有納入病例均完成冠脈檢查，圖像質量滿足診斷要求。9箇冠脈節段圖像評分、4箇冠脈節段增彊水平、圖像譟聲、SNR差異無明顯統計學意義， CNR、ED差異具有統計學意義。 A1組和A2組ED 分彆為（8ó．47±0．76） mSv和（12．22±2．41）mSv，B1和B2組ED分彆為（13．69±1．142）mSv和（20．31±1．36） mSv。結論對于超重和肥胖人群進行冠脈檢查，可通過降低kV減少檢查箇體的有效輻射劑量，降低冠脈圖像CNR。
목적：초보탐토통과강저kV강저초중화비반인군관상동맥CTA복사제량적가행성。방법련속수집초중환자60례、비반환자72례，매조균분성저제량조화상규제량조，분별기작A1화A2、B1화B2조， A1조채용100 kV、A2화B1조120 kV、B2조채용140 kV，대비제선용전해순（350 mg／ml）진행증소묘。대관상동맥9개주요절단도상진행주관평분，대우관상동맥근단（RCA-p）、좌주간LM（LMA）、좌전강지근단（LAD-p）、좌회선지근단（LCX-p）4개주요절단관강증강후CT치급SD화동수평전흉벽기육조직적CT치급SD진행기록。대A1화A2、B1화B2이상증강수평、도상평분、도상조성、신조비（ SNR）、조성비（ CNR）、유효복사제량（ ED）등진행분석비교。결과소유납입병례균완성관맥검사，도상질량만족진단요구。9개관맥절단도상평분、4개관맥절단증강수평、도상조성、SNR차이무명현통계학의의， CNR、ED차이구유통계학의의。 A1조화A2조ED 분별위（8ó．47±0．76） mSv화（12．22±2．41）mSv，B1화B2조ED분별위（13．69±1．142）mSv화（20．31±1．36） mSv。결론대우초중화비반인군진행관맥검사，가통과강저kV감소검사개체적유효복사제량，강저관맥도상CNR。
Objective To investigate the feasibility of reducing coronary CTA radiation dose through decreasing kV in overweight and obesity patients .Methods Sixty overweight patients and 72 obesity patients were selected consecutively .These patients were divided into low-dose group and conventional-dose group, which were denoted as group A 1,group A2,group B1 and group B2,respectively.100kV for group A1,120kV for group A2 and group B1,140kV for group B2.The contrast agent (iohexol, 350mg/ml) was used for enhancement scanning .The image quality of the nine major segments of coronary artery were evaluated by subjective scoring .The enhanced CT values of the four segments including proximal right coronary artery ( RCA-p) , left main artery ( LMA ) , proximal left anterior descending artery ( LADp-) , proximal left circumflex artery (LCX-p) and muscle tissue of chest wall at the same levels were recorded .The enhancement levels above A1,A2,B1,B2, image quality score,image noise,signal to noise ratio (SNR),contrast to noise ratio (CNR), effective radiation dose (ED) were analyzed and compared by means of two independent samples t -test.Results All the patients completed coronary artery examination,and the image quality met the diagnostic requirement .There were no significant differences in image score of 9 coronary segments ,enhancement levels , image noise and SNR of the four coronary segments , however , there were significant differences between CNR and ED.The ED in group A1 and A2 were (8.47 ±0.76) mSv and (12.22 ±2.41) mSv, respectively,which in group B1 and B2 were (13.69 ±1.142) mSv and (20.31 ±1.36) mSv,respectively.Conclusion The coronary artery examination for overweight and obesity patients can reduce kV to decrease effective radiation dosage and decrease coronary image CNR .
