第三代双源CT个体化“双低”技术在冠状动脉成像中的应用
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摘要
目的探讨第三代双源CT冠状动脉成像中应用低对比剂剂量、低对比剂注射流率技术的个体化注射方案对图像质量及辐射剂量的影响。方法将120例接受CT冠状动脉成像的患者随机分为2组。试验组:按照公式对比剂剂量=体质量×0.6ml/kg、流率=对比剂剂量/(5+扫描曝光时间),计算对比剂剂量和流率;对照组:对比剂50ml,流率5.0ml/s。2组均采用前瞻性心电门控窄窗技术扫描,比较2组图像质量的客观和主观评价指标及辐射剂量。结果试验组与对照组患者性别、年龄、体质量、体质量指数差异均无统计学意义(P均>0.05)。试验组与对照组注射对比剂剂量和对比剂流率差异均有统计学意义(P均<0.001)。2组图像SNR、冠状动脉图像质量评分和冠状动脉的可评价率差异均无统计学意义(P均>0.05)。心率≤70次/分、70次/分<心率≤80次/分及心率>80次/分时,试验组和对照组患者有效辐射剂量差异均有统计学意义(P均<0.05)。结论第三代双源CT冠状动脉血管成像个体化注射方式可在满足临床诊断的前提下最大程度地减少对比剂用量。
Objective To investigate image quality and radiation dose of the third generation dual-source CT with low dose contrast agent dosage and low velocity.Methods Totally 120 patients who underwent CT coronary artery angiography scanning were analyzed prospectively.The patients were randomly assigned to the study group and control group(each n=60).In study group,the dose and injection flow rate of contrast agent were determined according to the formula:Contrast agent dose=patients' body mass×0.6ml/kg,injection flow rate=contrast agent dose/(5+exposure time).In control group,the injection flow rate was 5.0ml/s,and the volume of contrast medium was 50 ml.Patients in both groups underwent prospective ECG gated narrow window scanning.Quantitative parameters,qualitative visual parameters and radiation dose were compared between the groups.Results No statistical difference was found in the gender,age,body mass and body mass index(all P>0.05),while a significant difference was found in the amount of consumed iodine and the velocity of contrast agent between the two groups(P<0.001).No statistical difference of SNR,images quality nor the proportion of evaluable numbers to all coronary numbers was found between the two groups(all P>0.05).For different heart rates(HR;HR≤70bpm,70 bpm80bpm),the effective dose had significant differences(all P<0.05).Conclusion The individualization of injection method in the third generation dualsource CT coronary artery angiography could minimize the amount of contrast agent while meet clinical requirements.
Objective To investigate image quality and radiation dose of the third generation dual-source CT with low dose contrast agent dosage and low velocity.Methods Totally 120 patients who underwent CT coronary artery angiography scanning were analyzed prospectively.The patients were randomly assigned to the study group and control group(each n=60).In study group,the dose and injection flow rate of contrast agent were determined according to the formula:Contrast agent dose=patients' body mass×0.6ml/kg,injection flow rate=contrast agent dose/(5+exposure time).In control group,the injection flow rate was 5.0ml/s,and the volume of contrast medium was 50 ml.Patients in both groups underwent prospective ECG gated narrow window scanning.Quantitative parameters,qualitative visual parameters and radiation dose were compared between the groups.Results No statistical difference was found in the gender,age,body mass and body mass index(all P>0.05),while a significant difference was found in the amount of consumed iodine and the velocity of contrast agent between the two groups(P<0.001).No statistical difference of SNR,images quality nor the proportion of evaluable numbers to all coronary numbers was found between the two groups(all P>0.05).For different heart rates(HR;HR≤70bpm,70 bpm
引文
[1]尹小花,徐荣,李春晨,等.冠状动脉CT血管成像预测冠状动脉斑块患者发生主要不良心脏事件的价值.中国医学影像技术,2017,33(10):1506-1511.
[2]刘杰,高剑波,郭华,等.腹主动脉CT血管成像的低剂量对比剂应用研究.中华放射学杂志,2011,45(12):1207-1210.
[3]吕培杰,柴亚如,阎晓朋,等.CT能谱智能匹配技术联合自适应统计迭代重组技术对腹部低对比剂量扫描图像质量和辐射剂量的影响.中华放射学杂志,2016,50(2):122-127.
[4]Darwish T.An evidence-based approach to minimise contrast induced nephropathy.N Z Med J,2009,122(1299):39-41.
[5]Ghadri JR,Kuest SM,Goetti R,et al.Image quality and radiation dose comparison of prospectively triggered low-dose CCTA:128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition.Int J Cardiovasc Imaging,2011,28(5):1217-1225.
[6]Kok M,Mihl C,Mingels AA,et al.Influence of contrast media viscosity and temperature on injection pressure in computed to mographic angiography:A phantom study.Invest Radiol,2010,256(1):32-61.
[7]Okada M,Nakashima Y,Nomura T,et al.Coronary vasodilation by the use of sublingual nitroglycerin using 64-slice dual-source coronary computed tomography angiography.J Cardiol,2015,65(3):230-236.
[8]柴雪,张龙江,周长圣,等.窦性心动过速患者双源CT冠状动脉成像:最佳期相及平均心率和心率变性对影像质量影像的研究.中国医学影像技术,2008,24(9):1311-1313.
[9]夏迎洪,亚力坤,依明,等.冠状动脉前瞻性心电门控窄窗采集技术在320排螺旋CT中的应用.CT理论与应用研究,2013,22(4):665-672.
[10]Nakaura T,Kidoh M,Sakaino N,et al.Low contrast-and low radiation dose protocol for cardiac CT of thin adults at 256-row CT:Usefulness of low tube voltage scans and the hybrid iterative reconstruction algorithm.Int J Cardiovasc Imaging,2013,29(4):913-923.
[11]Hein PA,May J,Rogalla P,et al.Feasibility of contrast material volume reduction in coronary artery imaging using 320-slice volume CT.Eur Radiol,2010,20(6):1337-1343.
[12]Lembcke A,Schwenke C,Hein PA,et al.High-pitch dualsouece CT coronary angiography with low volumes of contrast medium.Eur Radiol,2014,24(1):120-127.
[13]McLean K,Lilienfeld H,Caracciolo JT,et al.Management of isolated adrenal lesions in cancer patients.Can Control,2011,18(2):113-126.
[14]Datrice NM,Langan RC,Ripley RT,et al.Operative management for recurrent and metastatic adrenocortical carcinoma.J Surg Oncol,2012,105(7):709-713.
[2]刘杰,高剑波,郭华,等.腹主动脉CT血管成像的低剂量对比剂应用研究.中华放射学杂志,2011,45(12):1207-1210.
[3]吕培杰,柴亚如,阎晓朋,等.CT能谱智能匹配技术联合自适应统计迭代重组技术对腹部低对比剂量扫描图像质量和辐射剂量的影响.中华放射学杂志,2016,50(2):122-127.
[4]Darwish T.An evidence-based approach to minimise contrast induced nephropathy.N Z Med J,2009,122(1299):39-41.
[5]Ghadri JR,Kuest SM,Goetti R,et al.Image quality and radiation dose comparison of prospectively triggered low-dose CCTA:128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition.Int J Cardiovasc Imaging,2011,28(5):1217-1225.
[6]Kok M,Mihl C,Mingels AA,et al.Influence of contrast media viscosity and temperature on injection pressure in computed to mographic angiography:A phantom study.Invest Radiol,2010,256(1):32-61.
[7]Okada M,Nakashima Y,Nomura T,et al.Coronary vasodilation by the use of sublingual nitroglycerin using 64-slice dual-source coronary computed tomography angiography.J Cardiol,2015,65(3):230-236.
[8]柴雪,张龙江,周长圣,等.窦性心动过速患者双源CT冠状动脉成像:最佳期相及平均心率和心率变性对影像质量影像的研究.中国医学影像技术,2008,24(9):1311-1313.
[9]夏迎洪,亚力坤,依明,等.冠状动脉前瞻性心电门控窄窗采集技术在320排螺旋CT中的应用.CT理论与应用研究,2013,22(4):665-672.
[10]Nakaura T,Kidoh M,Sakaino N,et al.Low contrast-and low radiation dose protocol for cardiac CT of thin adults at 256-row CT:Usefulness of low tube voltage scans and the hybrid iterative reconstruction algorithm.Int J Cardiovasc Imaging,2013,29(4):913-923.
[11]Hein PA,May J,Rogalla P,et al.Feasibility of contrast material volume reduction in coronary artery imaging using 320-slice volume CT.Eur Radiol,2010,20(6):1337-1343.
[12]Lembcke A,Schwenke C,Hein PA,et al.High-pitch dualsouece CT coronary angiography with low volumes of contrast medium.Eur Radiol,2014,24(1):120-127.
[13]McLean K,Lilienfeld H,Caracciolo JT,et al.Management of isolated adrenal lesions in cancer patients.Can Control,2011,18(2):113-126.
[14]Datrice NM,Langan RC,Ripley RT,et al.Operative management for recurrent and metastatic adrenocortical carcinoma.J Surg Oncol,2012,105(7):709-713.