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双低剂量联合低流速注射在双源CT冠状动脉血管成像中的应用

汤振华

271200 山东新泰,泰山医学院附属新泰医院CT室

汤振华,Email: xttzh1974@163.com

摘 要:目的 探讨低管电压和低剂量对比剂、低流速注射在双源CT前瞻性心电触发大螺距扫描进行冠状动脉成像的可行性。方法 选取120例体质量指数(BMI)18.6~24.9 kg/m2和心率<65次/min的患者,A组60例采用120 kV管电压、对比剂剂量0.9 ml/kg、注射流速5.0 ml/s进行前瞻性心电触发门控扫描;B组60例采用80 kV管电压、对比剂剂量0.7 ml/kg、注射流速3.5 ml/s进行前瞻性心电触发大螺距扫描。对比剂均采用碘海醇350 mgI/ml,图像重建均采用迭代重建技术(SAFIRE)。测量2组的CT强化值和噪声,计算信噪比(SNR)、对比噪声比(CNR)。采用双盲法对冠状动脉以4分法进行评价,其中1分为不可诊断图像。结果 A组管腔内的平均强化CT值略高于B组,B组的图像噪声较A组略高,A组的SNR、CNR高于B组,差异均无统计学意义(P>0.05)。B组有效辐射剂量[(0.39±0.02)mSv]较A组显著降低[(4.99±1.36)mSv],差异有统计学意义(P<0.01)。结论 在BMI 18.6~24.9 kg/m2、心率<65次/min的患者中,应用双源CT前瞻性心电触发大螺距、低管电压、低对比剂剂量、低流速注射扫描,图像重建采用迭代重建,能够在保证冠状动脉图像质量的情况下,大幅度降低辐射剂量。

关键词:冠状血管; 体层摄影术,X线计算机; 辐射剂量; 对比剂

Double low dose combined with low velocity of flow injection in the application of the dual-source CT coronary angiography 

Tang Zhenhua.

Department of CT, Xintai Hospital Affiliated to Taishan Medical College, Xintai 271200, China

Tang Zhenhua, Email: xttzh1974@163.com

Abstract: Objective To discuss the feasibility of lower tube voltage and low dose of iodine- concentration contrast material, low velocity of flow injection in dual-source CT prospective ECG-trigger high pitch to scan for coronary artery imaging. Methods Selected 120 cases patients of body mass index (BMI) of 18.6 to 24.9 kg/m2, and heart rate<65 bpm. A group of 60 patients used 120 kV tube voltages, contrast media dosage 0.9 ml/kg, and injection rate of 5.0 ml/s to carry out prospective ECG-trigger scanning. B group of 60 cases used 80 kV tube voltage, contrast media dosage 0.7 ml/kg, injection rate of 3.5 ml/s to carry out prospective ECG-trigger high-pitch scan. Adopt iodine contrast media (Iohexol 350 mgI/ml) and iterative reconstruction technique (SAFIRE) was used in image reconstruction. Measured the values of CT enhanced images and noise of two groups, calculated the signal-to-noise ratio (SNR) and contrasted to noise ratio (CNR). The method of double blind was used to evaluate coronary artery in 4-point scale (1=non-diagnostic, 4=excellent) . Results The average enhanced CT attenuation of coronary artery in group A was slightly higher than group B; The image noise of group B was slightly higher than group A; SNR, CNR of group A was higher than group B, the difference was not statistically significant (P>0.05). Group B effective radiation dose (0.39±0.02)mSv was significantly lower in group A (4.99±1.36)mSv and had statistically significant difference (P<0.01). Conclusion In the patients of BMI 18.6 to 24.9 kg/m2, HR<65 bpm, the application of dual-source CT prospective ECG-trigger and high pitch, low voltage, low dose contrast media, low velocity of flow injection, image reconstruction using iterative reconstruction, can guarantee the quality of coronary artery image, and radiation dosage significantly reduces 91.8%.

Key words:Coronary, vessels; Tomography, X-ray computed; Radiation dosage; Contrast media

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文献标引:汤振华.双低剂量联合低流速注射在双源CT冠状动脉血管成像中的应用[J/CD].中华临床医师杂志:电子版,2017,11(4):555.

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