摘要
目的 研究冠状动脉CT血管成像（CCTA）中,双源CT大螺距模式的适宜低辐射剂量和低对比剂量.方法 从2013年9月至2014年2月苏州大学附属第一医院疑似冠心病的291例患者中,检查前挑选出体质指数（BMI） ＜23 kg/m2,且心率＜65次/min的患者135例,随机分为3组,每组45例.A组采用80 kV,碘克沙醇（320 mgI/ml）,正弦确认迭代重建算法（SAHRE）;B组采用80kV,碘普罗胺（370 mgI/ml）,SAFIRE;C组采用100kV,碘克沙醇,滤过反投影重建法（FBP）.采用独立样本t检验来分别比较A组和B组、A组和C组的图像质量的信噪比（SNR）对比噪声比（CNR）;同时比较A组和B组的碘摄人量、A组和C组的有效辐射剂量（ED）.结果 A组和B组的主动脉根部（AO）以及左主干（LM）,前降支（LAD）,回旋支（CX）,右冠状动脉（RCA）的SNR及CNR差异均无统计学意义,而碘摄入量分别为17 600和20 350 mg,A组碘摄入量减少14％.A组和C组的AO,LM,LAD,CX,RCA的SNR及CNR差异均无统计学意义;A组和C组的ED分别为（0.41±0.05）和（0.79 ±0.15）mSv,A组辐射剂量减小50％.结论 在BMI＜ 23 kg/m2,且心率＜ 65次/min的患者中,可以使用双源CT大螺距模式、80 kV、SAFIRE算法、碘克沙醇（320 mgI/ml）的双低扫描方案以减轻患者的辐射剂量和碘摄人量,同时图像质量不受影响.
Objective To evaluate the feasibility of low radiation exposure and low contrast medium volume for coronary CT angiography with High-pitch spiral acquisition mode of dual source CT.Methods 135 patients whose BMI ＜ 23 kg/m2 and heart rates ＜ 65 bpm selected from 291 patients diagnosed of suspected CHD at our institution from September 2013 to February 2014 were randomly divided into 3 groups before CCTA,and there were 45 patients in each group.80 kV,Iodixanol （320 mgI/ml） and sinogram affirmed iterative reconstruction（SAFIRE）were used in A group.80 kV,Iopamidol （370 mgI/ml）and SAFIRE were used in B group.100 kV,Iodixanol and filtered back projection（FBP） were used in C group.Two radiologists assessed image quality with 5-piont scale subjectively and double-blind.Independent-Sample Test was used to analyze statistical significance of image quality including signal to noise ratio（SNR） and contrast to noise ratio（CNR） between A and B group or between A and C group.At the same time,Contrast medium dose statistical significance between A and B group and mean effective Radiation dose （ED） statistical significance between A and C were analyzed by the same way.Results There were no significant difference of image quality including SNR and CNR of aortic root （AO）,left main coronary artery （LM）,left anterior descending artery （LAD）,circumflex coronary artery （CX） and right coronary artery （RCA） Between A and B group （P =non-significant for all comparison）,whereas Iodine intaken of A group decreased 14％ （17 600 mg vs 20 350 mg）.There were no significant difference of image quality including SNR and CNR of AO,LM,LAD,CX and RCA Between A and C group （P =non-significant for all comparison）,whereas mean ED of A group decreased 50％ （0.41 ± 0.05 mSv vs 0.79 ± 0.15 mSv）.Conclusion The double low dose application which use High-pitch spiral mode,80 kV,SAFIRE,andIodixanol（320 mgI/ml）can be used in those patients whose BMI ＜ 23 kg/m2 and heart rates ＜ 65
出处
《中华医学杂志》
CAS
CSCD
北大核心
2014年第29期2247-2250,共4页
National Medical Journal of China
