| 葛尚,李春和,潘昌杰,王涛,徐烈福.双源CT"双低"冠状动脉成像质量及辐射剂量的研究[J].中华放射医学与防护杂志,2015,35(3):226-230 |
| 双源CT"双低"冠状动脉成像质量及辐射剂量的研究 |
| Study on radiation dose and image quality for dual-source CT angiography under ‘double low’ Scan program |
| 投稿时间：2014-03-22 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.03.017 |
| 中文关键词: 辐射剂量 体层摄影术 冠状动脉 迭代重建 对比剂 |
| 英文关键词:Radiation dose Tomography Coronary artery Iterative reconstruction Contrast agent |
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| 中文摘要: |
| 目的 探讨双源CT低管电压、低对比剂浓度(双低)冠状动脉CT成像检查(coronary artery CT angiography,CCTA)的图像质量和辐射剂量。方法 160例疑有冠状动脉疾病的患者行CCTA检查,将80例BMI<25 kg/m2的患者按随机数字表法分成270 mg I/ml-80 kV组(A组)、350 mg I/ml-120 kV组(B组),另80例25≤BMI<30 kg/m2的患者按同样方法分成270 mg I/ml-100 kV组(C组)、350 mg I/ml-120 kV组(D组),每组40例。A、C两组采用迭代重建技术及270 mg I/ml的碘克沙醇,B、D两组采用滤波反投影技术及350 mg I/ml的碘海醇。各组均使用自适应前瞻性心电门控序列扫描技术,采集时相为65%~75%R-R间期(心率<75次/min)或40%~50%R-R间期(心率≥75次/min)。对每位患者的CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(E)、体型特异性剂量评估(SSDE)、图像噪声、冠状动脉CT值、信噪比(SNR)和对比噪声比(CNR)进行评估。结果 A、B组与C、D组间扫描长度差异无统计学意义。A、B组间管电流差异有统计学意义(t=8.932,P<0.05),C、D组间管电流差异无统计学意义(P>0.05)。A、B组与C、D组间CTDIvol、DLP、E和SSDE差异均有统计学意义(tCTDIvol=-16.141,-11.440;tDLP=-17.454,-10.521;tE=-17.444,-10.523;tSSDE=-13.032,-9.119,P<0.05)。与B组相比,A组SSDE下降了64.4%;与D组相比,C组SSDE下降了39.3%。A、B组与C、D组间噪声平均值差异无统计学意义(P>0.05)。A、B组间冠状动脉的平均CT值、平均SNR及平均CNR差异有统计学意义(t=0.436,4.623,3.272,P<0.05);C、D组间冠状动脉的平均CT值、平均CNR差异无统计学意义(P>0.05),平均SNR差异有统计学意义(t=2.981,P<0.05)。A、B组与C、D组间主观图像质量评分比较,差异无统计学意义(P>0.05)。结论 与常规双源CT冠状动脉成像方案相比,"双低"扫描方案可以大幅降低辐射剂量及对比剂使用量,并且所获得的冠状动脉图像仍能满足临床诊断需要。 |
| 英文摘要: |
| Objective To explore the image quality and radiation dose for coronary angiography using DSCT (dual-source computed tomography) under lower tube voltage and lower contrast agent concentration (‘double low’).Methods A total of 160 patients with suspected coronary artery disease underwent dual-source CCTA. 80 patients (BMI<25 kg/m2) were randomly assigned to group A (270 mg I/ml-80 kV) and B (350 mg I/ml-120 kV). The other 80 patients (25 ≤ BMI<30 kg/m2) were randomly assigned to group C (270 mg I/ml-100 kV) and D (350 mg I/ml-120 kV). sonogram affirmed iterative reconstruction technology and 270 mg I/ml contrast agent were applied to group A and C;FBP technology and 350 mg I/ ml contrast agent were applied to group B and D. Adaptive cardio-sequence prospective ECG-gated technology was applied in all patients,while the acquisition phase was 65%-75% RR interval (when heart rate<75 beats/min) or 40%-50% RR interval at when heart rate ≥ 75 beats/min. Volume CT dose index (CTDIvol),dose length product (DLP),effective dose (E),size specific dose estimates (SSDE),image noise,CT value,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR) were all evaluated for each patient.Results There was not statistical difference in scan length among groups A and B,C and D. There was statistical difference in tube current between group A and B (t=8.932,P<0.05). There was not statistical difference in tube current between group C and D (tCD=-1.212,P>0.05). There was statistical difference in CTDIvol,DLP,E and SSDE between group A and B,C and D (tCTDIvol=-16.141,-11.440;tDLP=-17.454,-10.521;t=-17.444,-10.523;tSSDE=-13.032,-9.119,P<0.05). Compared to group B,the SSDE in group A decreased by 64.4%. Compared to group D,the SSDE in group C decreased by 39.3%. There was no statistical difference in image noise between group A and B,C and D (P >0.05). There was statistical difference in CT value,SNR and CNR between group A and B(t=0.436,4.623,3.272,P<0.05). There was no statistical difference in CT value and CNR between group C and D, while there was statistical difference in SNR between group C and D (t=2.981,P<0.05). There was no statistical difference in image quality scores between group A and B,C and D (P >0.05).Conclusion Compared with conventional DSCT coronary angiography,‘double low’ DSCT coronary scanning solution can significantly reduce the radiation dose and contrast agent,and could provide the effective coronary images which meet the clinical diagnostic needs. |
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