CAJ | 학술논문

目的：探讨低浓度对比剂、低管电压联合迭代重建技术在急性脑梗死患者全脑灌注成像（CTP）中的可行性应用。方法：选取2014年9月－2015年3月在徐州医学院徐州临床学院行全脑 CTP 检查、临床拟诊为急性脑梗死患者59例，随机分为 A、B 两组，A 组28例[管电压100 kV，对比剂为碘海醇（350 mg I／mL），滤波反投影重建法（FBP）重建]；B组31例[管电压80 kV，对比剂为碘克沙醇（270 mg I／mL），迭代重建算法（ART）重建]。测量并计算 A、B 两组的大脑中动脉 CT 值、信噪比（SNR）、对比噪声比（CNR）、剂量长度乘积（DLP）、有效辐射剂量（ED）及碘摄入量，并对两组间上述指标进行统计学分析；2名医师对两组图像质量评价的一致性采用 kappa 分析；两组间图像质量主观评价差异采用χ2检验。结果：A、B 两组间的 CT 值、SNR、CNR、CTP 及 CTA 的图像主观质量评价差异均无统计学意义（P 均＞0．05）；两组间梗死灶的检出率无统计学差异；而 B 组（双低剂量组）的 ED、碘摄入量较 A 组低。结论：联合低管电压和迭代重建技术时，使用低浓度对比剂（270 mg I／mL）进行全脑 CTP 检查，在不降低图像质量的同时，还能减少 ED 及碘摄入量，从而降低对比剂肾病（CIN）的风险。
목적：탐토저농도대비제、저관전압연합질대중건기술재급성뇌경사환자전뇌관주성상（CTP）중적가행성응용。방법：선취2014년9월－2015년3월재서주의학원서주림상학원행전뇌 CTP 검사、림상의진위급성뇌경사환자59례，수궤분위 A、B 량조，A 조28례[관전압100 kV，대비제위전해순（350 mg I／mL），려파반투영중건법（FBP）중건]；B조31례[관전압80 kV，대비제위전극사순（270 mg I／mL），질대중건산법（ART）중건]。측량병계산 A、B 량조적대뇌중동맥 CT 치、신조비（SNR）、대비조성비（CNR）、제량장도승적（DLP）、유효복사제량（ED）급전섭입량，병대량조간상술지표진행통계학분석；2명의사대량조도상질량평개적일치성채용 kappa 분석；량조간도상질량주관평개차이채용χ2검험。결과：A、B 량조간적 CT 치、SNR、CNR、CTP 급 CTA 적도상주관질량평개차이균무통계학의의（P 균＞0．05）；량조간경사조적검출솔무통계학차이；이 B 조（쌍저제량조）적 ED、전섭입량교 A 조저。결론：연합저관전압화질대중건기술시，사용저농도대비제（270 mg I／mL）진행전뇌 CTP 검사，재불강저도상질량적동시，환능감소 ED 급전섭입량，종이강저대비제신병（CIN）적풍험。
Objective:To evaluate the influence of low tube voltage and low iodine-concentration contrast material on the image quality,the degree of blood vessels enhancement and radiation dose in the whole brain perfusion imaging (CTP). Methods:From September 2014 to March 2015,59 patients with clinical suspicion of acute cerebral infarction were enrolled in our center.They were randomly divided into two groups,and they all underwent CTP.Twenty-eight patients (group A) underwent examination with 100kV,350mg I/mL contrast medium and filter back-projection (FBP)reconstruction.Thirty-one patients (group B)underwent examination with 80 kV,270mg I/mL contrast medium and algebraic reconstruction tech-nique (ART).The middle cerebral artery CT value was measured.The CT value,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),dose length product (DLP),effective radiation dose (ED),and iodine intake of the two groups were compared and analyzed.Results:There was no significant difference in the CT value,subjective image quality score,SNR and CNR between the 2 groups.The ED and total iodine intake in group B were lower than that in group A.Conclusion:Low tube voltage,low concentration of contrast agent (270mg I/mL)combined with ART in the CTP do not reduce the quality of image.They can reduce the ED and the the risk of contrast induced nephropathy (CIN).