| 舒荣宝,仝开军,王岳松,严芳,罗潇,董学滨,周华飞,章聪.定位像胸部横径与CT值调制前瞻性序列扫描冠状动脉成像管电流的研究[J].中华放射医学与防护杂志,2015,35(7):550-554 |
| 定位像胸部横径与CT值调制前瞻性序列扫描冠状动脉成像管电流的研究 |
| Tube current modulation based on the lateral chest diameter and CT value on a scout view in prospectively ECG-gated CT coronary angiography |
| 投稿时间：2014-10-10 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.07.018 |
| 中文关键词: 冠状血管 辐射剂量 质量控制 计算机断层扫描 |
| 英文关键词:Coronary vessels Radiation dose Quality control Computed tomography |
| 基金项目:马鞍山市科技局科技计划项目(2012-k-z-04) |
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| 中文摘要: |
| 目的 探讨定位像胸部横径(LD)与平均CT值(CTchest)在前瞻性心电触发序列扫描冠状动脉成像(Prospective ECG-gated CT coronary angiography,PG CTCA)管电流调制中的临床应用价值。方法 将连续进行CTCA扫描的194例患者按例数不等的完全随机区段分组法分为3组,即回顾性心电触发序列组(RG组)69例,前瞻性心电触发序列组(PG1组)68例及PG2对照组57例。其中RG组固定600 mA扫描,于前后位定位像上测量第10胸椎椎体上缘水平LD、右侧膈肌上方锁骨中线处肋间隙的CTchest;相同高度侧位像胸部前后径(APD),以及CTCA图像冠状动脉左主干层面的升主动脉噪声(SD);拟合各测量参数与SD的关系,推算管电流换算公式及速查表。PG1组扫描管电流依据推导的管电流速查表进行选择。PG2组依据体质量固定选择管电流(< 77 kg者取400 mA,≥77 kg者取500 mA)。对3组图像质量评分、SD、CTDIvol、DLP、有效剂量(E)进行比较和评估。SD与LD、APD及CTchest的关系采用多元回归分析;3组间定位像胸部LD、CTchest、SD,以及CTDIvol、E比较均采用单因素方差分析;图像质量评分比较采用R×2列联表的χ2检验。 结果 管电流换算公式:mA=600/282 ·(0.487LD +0.064CTchest +13.7)2(R2=0.53,F=36.13,P=0.00)。3组胸部LD及CTchest大小比较,差异均无统计学意义(P > 0.05);SD、扫描毫安值和CTDIvol差异均有统计学意义(F=44.96、167.37和1 071.26,P < 0.05);但图像质量评分及可评估血管差异无统计学意义(χ2=6.89, 2.54,P > 0.05)。 结论 根据胸部定位像LD及CTchest选择PG CTCA个体化管电流,可在满足诊断需求的前提下,更科学合理地控制X射线剂量。 |
| 英文摘要: |
| Objective To investigate the clinical value of the patient's individually tube current modulation based on the lateral chest diameter(LD)and average CT value(CTchest)on a scout view in prospectively ECG-gated CT coronary angiography (PG CTCA). Methods Totally 194 consecutive patients were randomly divided into three groups:Group RG (retrospectively ECG-gated CTCA, 69 patients, standard protocol with a fixed 600 mA), Group PG1(prospectively ECG-gated CTCA, 68 patients) and PG2 (the control group, 57 patients). On the scout AP view, the chest LD was measured at the upper border of T10 vertebra; and the density (CTchest) was measured at the intercostal space of right midclavicular line above the diaphragm. The chest anteroposterior diameter(APD) were measured at the same level on the scout lateral view. The CTCA image noise was measured at the root of ascending aorta. A tube current conversion formula and quick list were conducted after matching the measured parameters with the noise. The tube current (mA) used in PG1 was determined by the list established previously. The tube current used in group PG2 wad fixed with reference to body mass (400 mA when < 77 kg; 500 mA when ≥77 kg). The image quality scores, image noise,volume CT dose index(CTDIvol), and effective dose(E) were evaluated for each patient.LD, CTchest, CTDIvol,DLP,E and image noise were all analyzed using one-way ANOVA analysis among 3 groups.And the image quality scores of the coronary artery were analyzed using R×2 contingency tables χ2 test. Results The tube current conversion formula was as mA=600/282 ·(0.487LD+0.064CTchest +13.7)2 (R2=0.53, F=36.13, P=0.00). There were no statistical differences among three groups in LD and CTchest on the scout view(P > 0.05). There were magnificent statistical differences among three groups in SD, mA, and CTDIvol (F=44.96,167.37, 1 071.26,P<0.05),There were also no statistical difference on image quality scores and the assessable vessels among 3 groups(χ2=6.89,2.54,P > 0.05).Conclusions Using the tube current determined by the individual chest LD and CTchest on the scout AP view would help to control the radiation in PG CTCA without damage of image quality and diagnostic accuracy. |
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