摘要
目的:探讨体质指数(BMI)、窄R-R间期结合前瞻性心电门控和迭代重建技术在CTCA三低(低管电压、低对比剂浓度、低对比剂用量)成像中的应用价值。方法:选取300例临床疑有冠状动脉疾病的患者行CTCA检查,分为常规组和实验组;常规组100例,对比剂浓度和管电压分别为350mg I/mL和120kV(350mg I/mL-120kV),BMI≤30kg/m^2;实验组200例,其中100例BMI<23kg/m^2的患者按随机数字法分成320mg I/mL-80kV组(A组)和350mg I/mL-120kV组(B组),另100例BMI为23~30kg/m^2的患者按同样方法分成320mg I/mL-100kV组(C组)和350mg I/mL-120kV组(D组),A、B、C、D每组各50例。常规组采用迭代重建技术及350mg I/mL的碘海醇,实验组中A、C两组采用迭代重建技术及320mg I/mL的碘克沙醇,B、D两组采用非迭代重建技术及350mg I/mL的碘海醇;对每位患者的CTCA图像进行主观评分,测量容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(ED)、图像噪声、冠状动脉CT值、信噪比(SNR)和对比噪声比(CNR),并进行统计学分析。结果:常规组与实验组的CTCA图像质量评分差异无统计学意义(P>0.05),而碘对比剂用量及辐射剂量两组差异均有统计学意义(P值均<0.05);实验组内A组与B组、C组与D组间图像质量主观评分差异均无统计学意义(P值均>0.05),而CTDIvol、DLP、ED差异均有统计学意义(P值均<0.05)。A组与B组、C组与D组的噪声及CT值差异均有统计学意义(P值均<0.05),A组与B组、C组与D组的平均SNR及平均CNR差异均无统计学意义(P值均>0.05)。结论:与常规双源CT冠状动脉成像方案相比,基于体质数、窄R-R间期结合前瞻性心电门控与迭代重建技术的CTCA,不仅可大幅降低辐射剂量,同时可以降低碘对比剂浓度和用量,所获得的冠状动脉图像质量均能满足临床诊断要求。
Objective：To investigate the value of body mass index（BMI）and narrow R-R interval in combination with prospective eletrocardiographic gating and iterative reconstruction techniques in the application of dual-source CT coronary angiography（CTCA）with ＂ Three-low＂（low tube voltage,low-concentration and low-dose）technique.Methods：Three hundred patients with suspected coronary artery disease underwent CTCA,which were divided into the conventional group and experimental group.There were 100 patients in the conventional group,350 mg I/mL of iodohexol were administrated,and the tube voltage was 120 kV,with BMI≤30kg/m^2.200 patients were in the experimental group,100 patients with BMI23kg/m^2 were randomly divided into group A（320mg I/mL 80kV）and group B（350mg I/mL 120kV）;the other 100 patients with BMI as 23-30kg/m^2 were also randomly divided into group C（320mg I/mL 100kV）and group D（350mg I/mL120kV）,with 50 cases in each subgroup.In the conventional group,iterative reconstruction technique and 350 mg I/mL of iodohexol were used.In the experimental group,iterative reconstruction technique and 320 mg I/mL iodixanol were used in Group A and Group C;non-iterative reconstruction technique and 350 mg I/mL iodohexol were sued in Group B and D.The image quality of CTCA were subjectively scored,CT dose index volume（CTDIvol）,dose length produce（DLP）,effective dosage（ED）,image noise,CT value of coronary artery,SNR and CNR were measured for each patient and statistically analyzes was performed.Results：There was no significant difference between the conventional and experimental group in the subjective image quality score of CTCA（P0.05）,yet there was significant difference in the amount of iodine contrast agent and radiation dose in these two groups（P0.05）.In the experimental group,no significant difference was found in the subjective image quality score between Group A and B,and Group C and D as well（P0.05）;while significant differences were found in CTDIvol,DLP and E
出处
《放射学实践》
北大核心
2017年第9期936-941,共6页
Radiologic Practice
基金
四川省教育厅科研课题(17ZB0483)
