| 梁晓雪,高剑波,梁丽丹,张亚歌,刘星.超重患者肺动脉CT血管成像70 kV/sn150 kV联合高级模拟迭代重建的图像质量评估[J].中华放射医学与防护杂志,2020,40(10):777-782 |
| 超重患者肺动脉CT血管成像70 kV/sn150 kV联合高级模拟迭代重建的图像质量评估 |
| Image quality assessment of computed tomography pulmonary angiography performed using a 70 kV/sn150 kV model combined with the advanced modeled iterative reconstruction method in overweight patients |
| 投稿时间：2020-05-28 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.10.008 |
| 中文关键词: 体质量指数 双能量 肺动脉CT血管成像 迭代重建 |
| 英文关键词:Body mass index Dual-energy Computed tomography pulmonary angiography Iterative reconstruction |
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| 中文摘要: |
| 目的 定量评价超重（25 kg/m2≤BMI<30 kg/m2）患者低剂量双能量（70 kV/sn150 kV）肺动脉成像中70 kVp、非线性融合联合高级模拟迭代重建（ADMIRE）图像的质量。方法 2018年10月至2019年3月行双源CT双能量肺动脉成像的可疑肺栓塞患者共70例，70 kV/sn150 kV扫描模式的体质量指数正常者及超重者各35例，对比剂用量均为30 ml。患者扫描后均获得70 kVp、150 kVp、线性融合及非线性融合图像，评估体质量指数正常者70 kVp （组1）、体质指数正常者非线性融合（组2）、超重者70 kVp （组3）、超重者非线性融合（组4）图像质量指标，包括肺动脉CT值、图像噪声（SD）、信噪比（SNR）、对比噪声比（CNR），辐射剂量参数包括CT容积剂量指数（CTDIvol）、剂量长度乘积（DLP）、有效剂量（E）。结果 4组肺动脉CT值差异无统计学意义（P>0.05）。段动脉SD值组1高于组4（t=2.69，P<0.05）。肺动脉主干、亚段动脉SNR值组2高于组3（t=1.44、5.40，P<0.05）。左肺动脉干SNR值组2高于组3、组4（t=1.52、1.52，P<0.05）。肺动脉主干、亚段动脉CNR值组2高于组3（t=1.45、5.01，P<0.05）。左肺动脉干CNR值组2高于组3、组4（t=1.50、1.50，P<0.05）。正常体质量指数组、超重组有效剂量为（1.60±0.54）、（1.88±0.45） mSv。结论 对于超重患者，肺动脉CT血管成像70 kV/sn150 kV双能量模式联合ADMIRE迭代重建的图像质量满足临床诊断，且对比剂用量及辐射剂量较低，是一种可行的双能量肺动脉扫描模式。 |
| 英文摘要: |
| Objective To evaluate the image quality of dual-source computed tomography pulmonary angiography (DE-CTPA) with low-dose contrast agent using the advanced modeled iterative reconstruction (ADMIRE) method with 70 kVp and non-linear blending in overweight patients. Methods Seventy patients (normal BMI, 35; overweight, 35) with suspected pulmonary embolization who underwent DE-CTPA between October 2018 and March 2019 were included in this study. The imaging protocol included assessments at 70 kV/sn150 kV with 30 ml of contrast agent, and images were obtained at 70 kVp and 150 kVp with and without linear blending. The CT value, SD value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of pulmonary arteries were compared and analyzed among groups 1 (70 kVp, normal BMI), 2 (non-linear blending, normal BMI), 3 (70 kVp, overweight), and group 4 (non-linear blending, overweight ). The radiation dose parameters included CT volume dose index (CTDIvol), dose length product (DLP), and effective dose (E ). Results The CT values for the pulmonary artery did not show significant differences among the four groups (P>0.05 ). The SD value of the segmental artery in group 1 was higher than that in group 4 (t=2.69,P<0.05 ). The SNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 (t=1.44, 5.40, P<0.05), while the corresponding value of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 (t=1.52, 1.52, P<0.05 ). The CNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 (t=1.45, 5.01, P<0.05) and that of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 (t=1.50,1.50, P<0.05 ). The E values for normal BMI and overweight patients were(1.60±0.54)mSv and(1.88±0.45)mSv, respectively. Conclusions For overweight patients, the CTPA protocol using ADMIRE with a 70 kV/sn150 kV scanning mode could yield diagnostic image quality with significantly lower radiation and contrast material doses. |
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