摘要
目的探讨低浓度对比剂和低管电压结合适应性统计迭代(ASIR)技术对腹部动脉血管成像(CTA)质量的影响。资料与方法前瞻性收集139例行全腹动态增强检查、体重指数(BMI)<22 kg/m2的患者,将其分为A组78例(管电压80 k Vp+50%ASIR,对比剂碘浓度270 mg I/ml)及B组61例(管电压120 k Vp,对比剂碘浓度350 mg I/ml)。评价两组右肾动脉的主观质量评分,对两组评分进行一致性检验;比较两组图像容积CT剂量指数(CTDIvol),腹主动脉主干及分支、右侧竖脊肌CT值,血管对比噪声比(CNR),右侧竖脊肌图像噪声(SD)及总碘量。结果两组图像的主观评分一致性很好(Kappa值>0.80),A、B组图像右肾动脉评分分别为(4.60±0.51)分和(3.81±0.76)分,差异有统计学意义(Z=-6.86,P<0.01)。A、B组CTDIvol分别为(5.56±4.21)m Gy、(7.11±1.54)m Gy,差异有统计学意义(t=-9.89,P<0.01);两组各动脉CT值均大于400 HU,A组腹主动脉主干及分支的CT值、CNR均高于B组(P<0.05);两组图像SD值差异无统计学意义(P>0.05);A、B组总碘量分别为270 mg、350 mg,A组较B组每位患者总碘量降低了22.86%。结论对于BMI<22 kg/m2的患者,低浓度对比剂、低管电压结合ASIR技术能够提高腹部CTA图像质量,并有效降低辐射剂量及对比剂碘含量。
Purpose To investigate the effect of low contrast dose and low tube voltage combined with adaptive statistical iterative reconstruction （ASIR） on image quality of abdominal CT angiography, Materials and Methods 139 patients with body mass index （BMI） 〈22 kg/m^2 who were supposed to undergo abdominal dynamic contrast-enhanced examination were prospectively enrolled and randomly divided into group A with 78 cases （80 kVp tube voltage ＋50% ASIR, contrast agent concentration 270 mgl/ml） and group B with 61 cases （120 kVp tube voltage, contrast agent concentration 350 mgl/ml）. Subjective score of right renal artery image quality of the two groups were evaluated and the coefficient between them was tested; CT dose index of volume （CTDIvol）, CT values of abdominal aorta and its branches, and the right side erector spinae, contrast-to- noise ratio （CNR） of the vessel, the right erector spinae image noise （SD）, and the total amount of iodine were also compared between the two groups. Results The inter observer agreement for subjective scores were very good （Kappa value〉0.80） in both groups, the subjective score of group A and group B were 4.60 4±0.51 and 3.81±0.76, respectively, and the difference was statistically significant （Z= - 6.86, P〈0.05）. CTDIvol of group A and group B were （5.56±4.21） mGy and （7.11 ± 1.54） mGy, respectively, the difference was statistically significant （t=- - 9.89, P〈0.01）; CT values of the arteries in both groups were all greater than 400 HU; CT values and the CNR of the abdominal aortic trunk and branches in group A were higher than those of group B （P〈0.05）; there was no statistically significant difference of image noise between the two groups （P〉0.05）. The total amount of iodine dose in group A and group B was 270 mg and 350 mg respectively, with a 22.86% reduce of the total iodine for each patient in A group than in B group. Conclusion For patients with BMI〈22 kg/m^2, it is feasible to use low dose contrast medium
出处
《中国医学影像学杂志》
CSCD
北大核心
2015年第4期260-263,共4页
Chinese Journal of Medical Imaging
关键词
主动脉
腹
肾动脉
脾动脉
肝动脉
肠系膜上动脉
体层摄影术
X线计算机
血管造影术
适应性统计迭代重建技术
造影剂
辐射剂量
Aorta,abdominal
Renal artery
Splenic artery
Hepatic artery
Mesenteric artery,superior
Tomography,X-ray computed
Angiography
Statistical iterative reconstruction
Contrast media
Radiation dosage
