摘要
目的探讨80 kV管电压联合个体化对比剂低剂量注射方案行颈动脉CT血管成像的可行性。方法前瞻性纳入需要行颈部CT血管成像(CTA)检查的136名患者,采用完全随机区段法分成A、B、C、D 4组,A组为100 kV 15 s团注常规组,53例;其他3组为80 kV 10 s团注对照组,根据≤50 kg、50~70 kg、70~90 kg体重分为B、C、D组,分别给予20、25和30 ml对比剂,B组20例,C组38例,D组25例。比较4组的有效剂量(E)、图像质量主观评价和客观指标。结果B、C、D 3组的E分别为(1.85±0.91)、(1.89±1.08)和(2.14±1.27)mSv,显著低于A组的(5.66±0.56)mSv,差异有统计意义(F=169.34,P<0.05),B、C、D组间两两比较差异无统计学意义(P>0.05)。4组图像的主观评价和诊断效果差异无统计学意义(P>0.05)。A组的颈总动脉CT值、信噪比(SNR)、对比噪声比(CNR)明显低于其他3组,差异均有统计意义(F=14.90、12.94、14.43,P<0.05),但所有颈动脉靶血管内CT值均在250 HU以上,均符合临床诊断要求。结论80 kV管电压10 s团注方案,可有效降低颈部CTA检查的辐射剂量和对比剂用量,而并不影响诊断效果。因此,该扫描方案可行且具有很大的临床应用价值。
Objective To investigate the feasibility of tube potential of 80 kV combined with personalized contrast agent protocol in carotid artery CT angiography(CTA).Methods A total of 136 consecutive patients undergoing neck CTA were prospectively enrolled in this study.The patients were randomly divided into Groups A,B,C and D.Tube potential of 100 kV and 15 s contrast agent injection protocol was used for Group A(53 cases)as conventional group,while tube voltage of 80 kV and 10 s contrast agent injection protocol was used for Groups B,C and D as experimental groups,with the contrast agent dosages of 20,25 and 30 ml used according to the body weights of≤50 kg(Group B,20 cases),50-70 kg(Group C,38 cases),and 70-90 kg(Group D,25 cases),respectively.The subjective and objective evaluation results of image quality and the effective doses were compared among the four groups.Results The effective doses in Groups B,C and D were 1.54±0.91,1.89±1.08 and 2.14±1.27 mSv,respectively,significantly lower than that in Group A[(5.66±0.56)mSv](F=169.34,P<0.05).The image quality of four groups met the requirements of clinical diagnosis.No significant differences were found in subjective evaluation and diagnostic efficacy of the four groups(P>0.05).The CT number of carotid artery,signal-to-noise ratio and contrast-to-noise ratio of the neck region were significantly lower in Groups B,C and D compared with Group A(F=14.9,12.94,14.43,P<0.05).The CT numbers of target carotid vessel were all higher than 250 HU.Conclusions The scanning protocol of low tube potential(80 kV)combined with 10 s contrast agent injection protocol could not only reduce the doses of radiation and contrast agent,but also preserve the diagnosis effect.Thus,this scanning protocol was feasible and valuable in clinical application.
作者
陈晓宇
曹国全
邓青山
张明月
杨运俊
王镇章
Chen Xiaoyu;Cao Guoquan;Deng Qingshan;Zhang Mingyue;Yang Yunjun;Wang Zhenzhang(Department of Radiology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2021年第4期299-303,共5页
Chinese Journal of Radiological Medicine and Protection
基金
浙江省卫生创新人才项目(20161107)。
关键词
颈动脉
CT血管成像
对比剂
辐射剂量
管电压
Carotid artery
CT angiography
Contrast medium
Radiation dose Tube voltage
