256层CT低管电压模式头部CTA降低对比剂用量的可行性研究
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摘要
目的:256层CT采用低电压扫描模式在头部CTA降低对比剂用量的可行性。方法:69例患者随机分为试验组和对照组。试验组采用80kV检查,对比剂用量40ml,对照组采用120kV检查,对比剂用量50ml。记录患者一般信息、辐射剂量,并测量肌肉、两侧颈总动脉、两侧颈内动脉、两侧椎动脉及两侧大脑中动脉的CT值和标准差,并计算对比噪声比(CNR)。由两位高年资医师对图像质量进行评分,统计分析主观图像质量和客观图像质量。结果:两组患者CT值除左侧椎动脉没有显著统计学差异(P=0.43)之外,其余均有显著统计学差异,且试验组血管CT值均高于对照组。而血管的CNR无统计学差异(P>0.05)。试验组主观图像评分(4.47±0.66)显著高于对照组(4.11±0.63,P<0.05)。试验组CTDIvol(21.93mGy)较对照组CTDIvol(26.5mGy)降低了21%。结论:采用低电压扫描模式的头部CTA检查在降低辐射剂量的同时,可以降低对比剂用量,并且图像质量有明显提高。
Purpose: To study the feasibility of reducing the dosage of contrast agent in the head CTA by low voltage scan mode of 256-slice CT. Methods: Sixty-nine patients were randomly divided into experimental group and control group. The experimental group was scanned with 80 kV, the dosage of contrast agent was 40 ml, the control group was scanned with 120 kV, and the dosage of contrast agent was 50 ml. The general information of the patients was recorded. The CT values and standard deviations of the muscle, both side of common carotid artery, internal carotid artery, vertebral artery, middle cerebral arteries were measured and the CNR was calculated. The image quality was scored by two senior radiologists. The subjective image quality and objective image quality were analyzed. Results: The CT values between the two groups were with statistical significant difference except the left vertebral artery(P = 0.43), and the CT value of the experimental group was higher than that of the control group. There was no statistical significant difference of the contrast noise ratio(CNR) of the vessels between the two groups(P> 0.05). The subjective scores of the experimental group and the control group were 4.47 ± 0.66 and 4.11 ± 0.63, the difference of the subjective image quality scores between the two groups were with statisticalsignificant(P <0.05), and the subjective score of the experimental group was higher than that of the control group. The average CTDIvol of the experimental group was 21.93 mGy, and the CTDIvol of the control group was 26.5 mGy, compared with the control group, the radiation dose of the experimental group was decreased by 21%. Conclusion: The CTA with low-voltage scan mode can be used to reduce the dosage of the contrast agent while reduce the radiation dose. The CT value and subjective image quality of CTA examination in the experimental group were significantly higher than those in the control group.
Purpose: To study the feasibility of reducing the dosage of contrast agent in the head CTA by low voltage scan mode of 256-slice CT. Methods: Sixty-nine patients were randomly divided into experimental group and control group. The experimental group was scanned with 80 kV, the dosage of contrast agent was 40 ml, the control group was scanned with 120 kV, and the dosage of contrast agent was 50 ml. The general information of the patients was recorded. The CT values and standard deviations of the muscle, both side of common carotid artery, internal carotid artery, vertebral artery, middle cerebral arteries were measured and the CNR was calculated. The image quality was scored by two senior radiologists. The subjective image quality and objective image quality were analyzed. Results: The CT values between the two groups were with statistical significant difference except the left vertebral artery(P = 0.43), and the CT value of the experimental group was higher than that of the control group. There was no statistical significant difference of the contrast noise ratio(CNR) of the vessels between the two groups(P> 0.05). The subjective scores of the experimental group and the control group were 4.47 ± 0.66 and 4.11 ± 0.63, the difference of the subjective image quality scores between the two groups were with statisticalsignificant(P <0.05), and the subjective score of the experimental group was higher than that of the control group. The average CTDIvol of the experimental group was 21.93 mGy, and the CTDIvol of the control group was 26.5 mGy, compared with the control group, the radiation dose of the experimental group was decreased by 21%. Conclusion: The CTA with low-voltage scan mode can be used to reduce the dosage of the contrast agent while reduce the radiation dose. The CT value and subjective image quality of CTA examination in the experimental group were significantly higher than those in the control group.
引文
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[10]胡茂清,梁长虹.规范碘对比剂在CT增强扫描中的应用.中华放射学杂志,2014,48:793-794..
[11]牛朋影,蒋磊,刘渊,等.双能量CT不同技术在低剂量对比剂头颈CTA图像优化中的对比.中国医学影像技术,2017,33:285-289.
[12]曹治婷,刘铁军,陈刚,等.低管电压结合低对比剂碘量在支气管动脉CT成像的应用.中国医学计算机成像杂志,2017,23:407-411
[2]李姝琪,郭君武.双源CT双低扫描在头颈部血管成像中的应用.中华老年医学杂志,2015,34:502-505.
[3]姚金龙,邹国林,包义红,等.100k V低管电压扫描与i Dose4重建并用在头颈联合CTA检查中的应用价值.中华全科医学,2016,14:1196-1198.
[4]李杨,隋庆兰,刘霞,等.头颈部血管造影中应用256层螺旋CT低管电压、低浓度对比剂及个性化对比剂用量的可行性.中国医学影像技术,2016,32:609-613.
[5]Niesten JM,van der Schaaf IC,Vos PC,et al.Improving head and neck CTA with hybrid and model-based iterative reconstruction techniques.Clin Radiol,2015,70:1252-1259.
[6]杜煜,时高峰,王亚宁.探讨双源CT颈动脉造影低管电压扫描的可行性.中国医学影像技术,2012,28:2079-2082.
[7]Piechowiak E I,Peter J F,Kleb B,et al.Intravenous Iodinated Contrast Agents Amplify DNA Radiation Damage at CT.Radiology,2015,275:692-697.
[8]Kondratyev E,Karmazanovsky G.Low radiation dose 256-MDCTangiography of the carotid arteries:effect of hybrid iterative reconstruction technique on noise,artifacts,and image quality.European Journal of Radiology,2013,82:2233-2239.
[9]张志鹏,钟佳利,杜司续,等.“双低”技术在头颈部动脉成像滤波反投影算法中可行性研究.医学影像学杂志,2016,26:757-761.
[10]胡茂清,梁长虹.规范碘对比剂在CT增强扫描中的应用.中华放射学杂志,2014,48:793-794..
[11]牛朋影,蒋磊,刘渊,等.双能量CT不同技术在低剂量对比剂头颈CTA图像优化中的对比.中国医学影像技术,2017,33:285-289.
[12]曹治婷,刘铁军,陈刚,等.低管电压结合低对比剂碘量在支气管动脉CT成像的应用.中国医学计算机成像杂志,2017,23:407-411