CAJ | 학술논문

目的：探讨128层双源CT联合低管电压和低剂量对比剂在法洛四联症（TOF）患儿血管成像中的应用。方法前瞻性收集TOF患儿40例，按照随机数字表法等分为A、B两组，管电压和对比剂用量分别为80 kVp、1.2 ml/kg（A组），70 kVp、1.0 ml/kg（B组），对比剂注射时间均固定为12 s。测量两组患儿图像升主动脉近端、肺动脉主干及左、右心室的CT值、噪声及信噪比，并对图像质量进行主观评分，同时记录两组患儿的辐射剂量及对比剂用量。组间各测量部位的CT值、噪声、信噪比及组间辐射剂量、对比剂用量的差异采用两样本t检验进行比较，组间图像质量主观评分的差异采用Mann-Whitney U秩和检验进行比较。结果40例患儿均顺利完成检查，两组间各测量部位的CT值、噪声、信噪比及图像质量主观评分差异均无统计学意义（P值均>0.05），A、B两组有效辐射剂量分别为（0.17±0.05）、（0.13±0.04）mSv，对比剂用量分别为（10.00±1.84）、（8.29±1.45）ml，两组间差异均具有统计学意义（t值分别为2.48、2.89，P值均<0.05）。结论 TOF患儿128层双源CT血管成像联合低管电压和低剂量对比剂可获得满意的图像质量，可降低辐射剂量及对比剂用量，具有良好的临床应用价值。
목적：탐토128층쌍원CT연합저관전압화저제량대비제재법락사련증（TOF）환인혈관성상중적응용。방법전첨성수집TOF환인40례，안조수궤수자표법등분위A、B량조，관전압화대비제용량분별위80 kVp、1.2 ml/kg（A조），70 kVp、1.0 ml/kg（B조），대비제주사시간균고정위12 s。측량량조환인도상승주동맥근단、폐동맥주간급좌、우심실적CT치、조성급신조비，병대도상질량진행주관평분，동시기록량조환인적복사제량급대비제용량。조간각측량부위적CT치、조성、신조비급조간복사제량、대비제용량적차이채용량양본t검험진행비교，조간도상질량주관평분적차이채용Mann-Whitney U질화검험진행비교。결과40례환인균순리완성검사，량조간각측량부위적CT치、조성、신조비급도상질량주관평분차이균무통계학의의（P치균>0.05），A、B량조유효복사제량분별위（0.17±0.05）、（0.13±0.04）mSv，대비제용량분별위（10.00±1.84）、（8.29±1.45）ml，량조간차이균구유통계학의의（t치분별위2.48、2.89，P치균<0.05）。결론 TOF환인128층쌍원CT혈관성상연합저관전압화저제량대비제가획득만의적도상질량，가강저복사제량급대비제용량，구유량호적림상응용개치。
Objective To investigate the effectiveness and feasibility of cardiovascular computed tomography angiography(CTA) in 128-slice DSCT with low tube voltage and low dosage contrast media in children with tetralogy of Fallot (TOF). Methods Forty patients with TOF were randomly divided into group A and group B by random number table method, patients in group A received a conventional scan with 80 kVp and contrast media of 1.2 ml/kg, patients in group B, 70 kVp and contrast media of 1.0 ml/kg were used. The injection time of the two groups were both fixed for 12 s. CT attenuation, image noise and signal-to-noise ratio (SNR) of ascending aorta, the main pulmonary artery, left ventricle and right ventricle were quantified. Radiation dose and volume of the contrast medium were recorded. Subjective image quality was assessed by two radiologists in consensus. The Student's t test was performed to analyse the differences between the two groups regarding CT attenuation, image noise, SNR, radiation dose and volume of the contrast medium. The image quality scores between the two groups were compared by using the Mann-Whitney U test. Results No significant difference was found in the attenuation, noise, SNR between the two groups in the same evaluated anatomic regions and no significant difference was found in the image quality. Effective dose (ED) was(0.17±0.05),(0.13±0.04)mSv respectively, there was significant reduction in group B than that in group A (t=2.48, P=0.019). The consumed iodine amount was(10.00±1.84),(8.29± 1.45) ml respectively, there was significant reduction between the two groups (t=2.89, P=0.007). Conclusions In children with TOF, the cardiovascular CTA with diagnostic quality can be adequately acquired with low tube voltage (70 kVp) and low concentration contrast media (1.0 ml/kg), there is significant reduction in radiation dose and contrast medium amount.