CAJ | 학술논문

目的：评价在不同碘浓度对比剂和不同管电压的条件下采用非迭代重建技术后冠状动脉 CTA 的图像质量，并探讨其临床价值。方法：选取解放军第九七医院2014年5－10月50例临床怀疑冠心病的患者，随机分为 A、B 两组，每组25例，A 组检查条件为管电压120 kVp、对比剂碘浓度370 mg I／mL；B 组为管电压100 kVp、对比剂碘浓度270 mg I／mL。对2组患者行冠状动脉 CTA 检查后，图像采用滤过反投影（FBP）法进行重建，分别测量及计算右冠状动脉（RCA）近段及左冠状动脉主干（LMA）的 CT 值、信噪比（SNR）、对比信噪比（CNR）、图像质量主观评分、CT 容积剂量指数（CT-DIvol）、剂量长度乘积（DLP）及有效辐射剂量（ED）。结果：2组间 RCA 近段、LMA 管腔内 CT 值、SNR、CNR 及图像质量主观评分的差异均无统计学意义（P ＞0．05），而2组间 CTDIvol、DLP 及 ED 比较 B 组均低于 A 组，有统计学意义（P ＜0．05）。结论：低碘浓度对比剂（270 mg I／mL）联合低 kV（100 kVp）通过非迭代重建技术仍可获得管电压120 kVp 及对比剂碘浓度370 mg I／mL 扫描条件下相同质量的图像，不仅可以满足诊断需要，还可以减低辐射剂量。
목적：평개재불동전농도대비제화불동관전압적조건하채용비질대중건기술후관상동맥 CTA 적도상질량，병탐토기림상개치。방법：선취해방군제구칠의원2014년5－10월50례림상부의관심병적환자，수궤분위 A、B 량조，매조25례，A 조검사조건위관전압120 kVp、대비제전농도370 mg I／mL；B 조위관전압100 kVp、대비제전농도270 mg I／mL。대2조환자행관상동맥 CTA 검사후，도상채용려과반투영（FBP）법진행중건，분별측량급계산우관상동맥（RCA）근단급좌관상동맥주간（LMA）적 CT 치、신조비（SNR）、대비신조비（CNR）、도상질량주관평분、CT 용적제량지수（CT-DIvol）、제량장도승적（DLP）급유효복사제량（ED）。결과：2조간 RCA 근단、LMA 관강내 CT 치、SNR、CNR 급도상질량주관평분적차이균무통계학의의（P ＞0．05），이2조간 CTDIvol、DLP 급 ED 비교 B 조균저우 A 조，유통계학의의（P ＜0．05）。결론：저전농도대비제（270 mg I／mL）연합저 kV（100 kVp）통과비질대중건기술잉가획득관전압120 kVp 급대비제전농도370 mg I／mL 소묘조건하상동질량적도상，불부가이만족진단수요，환가이감저복사제량。
Objective:To evaluate the image quality of different tube voltage with different iodine concentration con-trast agent in coronary artery computed tomography angiography (CTA),and discuss its clinical value.Methods:Fifty pa-tients underwent coronary artery CTA,and they were randomly assigned to 2 groups,Group A (n=25)was scanned using 120kVp and 370mg I/mL iodine concentration contrast agent,Group B (n=25)was scanned using 100kVp and 270mg I/mL i-odine concentration contrast agent,images were reconstructed using filtered back projection (FBP).Then CT attenuation of two main branches (proximal RCA and LMA)of coronary artery,SNR,CNR,subjective scoring of image quality,volume CT dose idex (CTDIvol),dose length product (DLP)and effective dose (ED)were measured and compared.Results:The coronary artery CT attenuation,SNR,CNR and subjective scoring of the two groups had no statistically significant differ-ences (P value>0.05),but the CTDIvol,DLP and ED of the two groups were statistically different (P value <0.05),and the data of Group B were all lower than those of Group A.Conclusion:The coronary artery CTA using 100kVp with 270mg I/mL iodinated contrast agent can provide similar image quality as compared with CTA using 120kVp and 370mg I/mL with non-iterative reconstruction,thus enabling to reduce radiation dose without loss of diagnostic information.