| 富青,杨明,雷子乔,余建明.基于第3代双源CT双低检查技术在肺栓塞成像的临床应用研究[J].中华放射医学与防护杂志,2020,40(9):712-716 |
| 基于第3代双源CT双低检查技术在肺栓塞成像的临床应用研究 |
| Clinical study of pulmonary embolism CT imaging using the third generation dual-source CT with low tube voltage and low contrast dosage |
| 投稿时间：2020-04-03 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.09.011 |
| 中文关键词: 第3代双源CT CT肺动脉成像 肺栓塞 低管电压 辐射剂量 |
| 英文关键词:Third generation dual-source CT CT pulmonary angiography Pulmonary embolism Low tube voltage Radiation dose |
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| 中文摘要: |
| 目的 探讨第3代双源CT大螺距70 kV联合超低对比剂用量16 ml在肺栓塞低辐射剂量成像的临床应用价值。方法 将83例临床可疑肺栓塞行CT肺动脉成像患者，按随机数表法，分为两组：常规组，36例，管电压100 kV，螺距1.0，对比剂总量60 ml；双低组，47例，管电压70 kV，螺距2.2，对比剂总量16 ml。记录两组的容积CT剂量指数（CTDIvol）和剂量长度乘积（DLP）以计算有效剂量（E），测量各级肺动脉增强CT值、背景噪声及肌肉CT值以计算信噪比（SNR）、对比噪声比（CNR）。两组的总体图像质量和上腔静脉引起的线束硬化伪影均采取3级评分进行主观评价。结果 两组患者之间性别、年龄、身高、体重、体质量指数（BMI）、肺栓塞比例及各级肺动脉增强CT值差异均无统计学意义（P>0.05）。双低组E为（0.76±0.13）mSv，常规组为（1.91±0.54）mSv，两组比较差异有统计学意义（Z=-5.23，P<0.001）。双低组背景噪声高于常规组（Z=-4.99，P<0.001），且SNR和CNR均低于常规组（Z=-4.56、-4.48，P<0.001），但两组总体图像质量主观评分差异无统计学意义（P>0.05），且双低组上腔静脉引起的线束硬化伪影评分（1.34±0.60）低于常规组（2.94±0.23），两组比较差异有统计学意义（Z=-5.15，P<0.001）。结论 第3代双源CT大螺距70 kV联合16 ml超低对比剂用量，可以显著降低对比剂线束硬化伪影对右肺动脉、右肺上叶动脉的干扰，保证肺栓塞诊断图像质量，并大幅度降低辐射剂量约60%，同时减少73%对比剂总量。 |
| 英文摘要: |
| Objective To investigate the clinical value of third-generation dual-source CT with high pitch, 70 kV combined with 16 ml contrast agent in low radiation dose imaging of pulmonary embolism (PE). Methods Eighty-three patients with suspected PE underwent CT pulmonary angiography were randomly divided into two groups:group A with 36 cases, 100 kV, 1.0 pitch, and 60 ml contrast agent; group B with 47 cases, 70 kV, 2.2 pitch, and 16 ml contrast agent. The volume CT dose index and dose length product of the two groups were recorded to calculate the effective dose E, and the CT values of enhanced pulmonary arteries, background noise, and muscles values were recorded to calculate signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The overall image quality and the beam-hardening artifact of superior vena cava were subjectively evaluated on a 3-point scale. Results There were no significant differences in gender, age, height, weight, BMI, proportion of PE, and CT values of enhanced pulmonary arteries at all levels (P>0.05). The value E of group B was (0.76±0.13) mSv, significantly lower than that in group A[(1.91±0.54) mSv, Z=-5.23, P<0.001]. Although background noise of group B was significantly higher than that of group A (Z=-4.99, P <0.001), SNR and CNR values of group B were significantly lower than those of group A (Z=-4.56,-4.48,P<0.001), there was no statistically significant difference in the overall image quality scores between the two groups (P>0.05). The beam-hardening artifact caused by superior vena cava in group B was significantly lower than that in group A (Z=-5.15, P <0.001). Conclusions The third generation dual-source CT with high pitch, 70 kV combined with 16 ml contrast agent can significantly reduce the interference of contrast agent beam-hardening artifact on the right and right superior pulmonary arteries to ensure the diagnostic image quality of PE, and effectively reduce radiation dose by 60% and total volume of contrast agent by 73%. |
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