CAJ | 학술논문

目的：探讨第二代双源(炫速双源)CT冠状动脉成像中，应用迭代重建算法与等渗低浓度对比剂及低电压技术时的图像质量及辐射剂量。方法收集宁波市第二人民医院及浙江省立同德医院2014年3月~2015年3月的80例冠心病患者(BMI<30 kg/m2,心率<65次/min)按CT号码的单双号分成A、B两组，每组各40例。两组均采用冠状动脉双源CT前瞻性大螺距扫描，A组采用低电压和低浓度对比剂及迭代重建(SAFIRE)进行冠状动脉CT检查；B组采用常规电压及常规浓度对比剂及滤波反投影(FBP)对冠状动脉进行重建。两位有经验的心血管系统诊断医师采用双盲法,以5分法评定系统对冠状动脉16段分支血管成像质量进行评分，对两组有效辐射剂量、平均CT值、图像噪声、信噪比(SNR)、对比信噪比(CNR)、图像质量评分进行比较。采用t检验比较计量资料组间差异。结果两组患者一般资料、辐射剂量、图像质量比较，除了辐射剂量中的管电流具有统计学差异(P<0.05)外，其余差异均无统计学意义(P>0.05)。两组CNR、SNR、CT值比较差异均无统计学意义(P>0.05)。结论在BMI<30 kg/m2,心率<65次/min条件下，前瞻性大螺距扫描、迭代重建算法和低浓度非离子型造影剂及低管电压综合的多种技术进行冠状动脉CTA检查时，可以使辐射剂量明显降低且对冠状动脉诊断的准确性无明显影响。
목적：탐토제이대쌍원(현속쌍원)CT관상동맥성상중，응용질대중건산법여등삼저농도대비제급저전압기술시적도상질량급복사제량。방법수집저파시제이인민의원급절강성립동덕의원2014년3월~2015년3월적80례관심병환자(BMI<30 kg/m2,심솔<65차/min)안CT호마적단쌍호분성A、B량조，매조각40례。량조균채용관상동맥쌍원CT전첨성대라거소묘，A조채용저전압화저농도대비제급질대중건(SAFIRE)진행관상동맥CT검사；B조채용상규전압급상규농도대비제급려파반투영(FBP)대관상동맥진행중건。량위유경험적심혈관계통진단의사채용쌍맹법,이5분법평정계통대관상동맥16단분지혈관성상질량진행평분，대량조유효복사제량、평균CT치、도상조성、신조비(SNR)、대비신조비(CNR)、도상질량평분진행비교。채용t검험비교계량자료조간차이。결과량조환자일반자료、복사제량、도상질량비교，제료복사제량중적관전류구유통계학차이(P<0.05)외，기여차이균무통계학의의(P>0.05)。량조CNR、SNR、CT치비교차이균무통계학의의(P>0.05)。결론재BMI<30 kg/m2,심솔<65차/min조건하，전첨성대라거소묘、질대중건산법화저농도비리자형조영제급저관전압종합적다충기술진행관상동맥CTA검사시，가이사복사제량명현강저차대관상동맥진단적준학성무명현영향。
Objective To evaluate the image quality and radiation dosage of dual-source CT iterative reconstruction algorithm combined with low tube voltage and low concentration contrast agent imaging for coronary artery. Methods From March 2014 to March 2015, 80 patients ( BMI <30 kg/m2, heart rate < 65 times/min) from the Second People's Hospital and Tongde Hospital of Zhejiang Province were enrolled into two groups (group A, group B) based on odd or even CT number in this study,40 cases in each group. Dual-source CT large pitch imaging scanning technique for coronary artery was applied to all patients. Patients in group A were scanned with low voltage and low concentration of contrast agent and iterative reconstruction (SAFIRE) for coronary artery CT examination;while patients in group B were scanned with normal regular voltage and concentration of contrast medium and filter back projection place (FBP) for coronary artery reconstruction. Image quality of 16 coronary artery branches were scored with 5 points method assessment system by two experienced cardiovascular diagnosis physicians, and the differences of the effective radiation dose, the average CT value and image noise, the signal-to-noise ratio(SNR), contrast signal to noise ratio (CNR), image quality scores were compared between two groups, using double blind evaluation system. T test was performed between measureme nt data sets. Results Statistical differences was found in the tube current radiation dose (t = 0.148, P <0.05). No statistical differences was found in the general information, radiation dose and image quality (P>0.05). CNR, SNR, CT value showed no statistical differences between the two groups (P > 0.05). Conclusion The radiation dose decreases obviously when prospective big pitch scanning technology, the iterative reconstruction, technology of the low concentration of contrast medium and low voltage coronary CTA examination performed under the condition of BMI <30 kg/m2, heart rate<65 times/min. No obvious effect revealed on the accuracy of the coronary artery diagnosis.