摘要
目的探讨肺动脉栓塞(PE)患者行CT血管成像(CTPA)检查时,低剂量、等渗低浓度对比剂联合低辐射迭代重建技术在降低对比剂剂量及浓度的同时保持图像质量的可行性。方法选取2015年11月至2017年10月于我院行CTPA检查最终确诊为PE的患者46例为研究对象,随机分为对照组和试验组,各23例。对照组采用常规剂量碘对比剂(碘帕醇),浓度为370 mg I/mL,对比剂用量1 mL/kg;试验组采用低剂量、等渗低浓度碘对比剂(碘克沙醇),浓度为270 mg I/mL,对比剂用量0.5 m L/kg。两组管电压均设为100 k V,自动管电流,采用iDose4迭代重建算法重建,其余扫描参数一致。对两组的图像进行测量和质量评分,测量每例患者肺动脉主干和肺叶动脉的CT值,肺动脉亚段及栓子显示率,计算各组的噪声、信噪比(SNR)、对比度噪声比(CNR);按1~5分对图像质量进行主观评价。比较两组的测量结果。结果两组图像质量的主观评分比较,无显著差异(P>0.05);图像噪声客观评价结果显示,两组肺动脉主干、肺叶动脉的CT值、SNR、CNR及SD与斜方肌及前胸壁脂肪的CT值及SD比较,差异无统计学意义(P>0.05)。试验组有效碘摄入量及造影剂用量明显少于对照组(P<0.01)。结论 PE患者行CTPA检查时,采用低剂量、等渗低浓度碘对比剂造影并联合低剂量迭代重建算法重建,在保持肺动脉图像质量满足临床诊断的前提下,显著减少了碘对比剂用量。
Objective To investigate the feasibility of mainta ining image quality of CTPA examination for pulmonary embolism（PE） patients with low-dosed, isotonic and low-concentration contrast agent and low-radiation iterative reconstruction technique while reducing the contrast dose and concentration. Methods Forty-six PE patients who performed CTPA examination in our hospital from November 2015 to October 2017 were enrolled and randomly divided into control group and experimental group, with 23 cases in each group. The control group was given iodine contrast agent（iopamidol） in conventional dose： concentration of 370 mg I/m L, dosage of contrast agent 1 m L/kg; and the experimental group used low-dosed,isotonic and low-concentration contrast agent（iodixanol）： concentration of 270 mg I/m L, dosage of contrast agent 0.5 m L/kg.Both groups used automatic tube current of 100 k V, tube voltage and iterative reconstruction technique（i Dose4）, and the rest of scanning parameters were consistent. The image quality in the two groups were measured and scored. The CT values of the main pulmonary artery and the pulmonary arterial branch and display rate of pulmonary subsegment and emboli in each patient were measured, the noise, SNR and CNR were calculated, and the images quality were evaluated subjectively by 1-5 points. The results of the two groups were compared. Results There were no significant differences in the subjective score of image quality between the two groups（P〉0.05）. The objective evaluation results of image noise showed that there were no significant differences in the CT value, SNR, CNR and SD of the main pulmonary artery and the pulmonary arterial branch,the CT value and SD of trapezius muscle and anterior chest wall fat between the two groups（P〉0.05）. The dosage of contrast agent and effective iodine intake in the experimental group were obviously lower than those in the control group（P〈0.01）.Conclusion On the premise of maintaining the image quality of pulmonary artery to me
作者
董燕
刘润
杨军乐
宁文德
刘静
刘文昌
曲长君
公婷
DONG Yan;LIU Run;YANG Jun-le;NING Wen-de;LIU Jing;LIU Wen-chang;QU Chang-jun;GONG Ting(Radiology Department, Xi＇an Central Hospital, the Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710003;Radiology Department, Traditional Chinese Medicine Hospital of Xi＇an, Xi＇an 710021, China)
出处
《临床医学研究与实践》
2018年第12期1-4,共4页
Clinical Research and Practice
基金
陕西省科技厅社发攻关计划项目(No.2014K12-10)
关键词
体层摄影术
低剂量造影剂
低浓度
迭代重建技术
肺动脉栓塞(PE)
tomography
low -dosed contrast agent
low concentration
iterative reconstruction technique
pulmonaryembolism （PE）
