64层螺旋CT肺动脉成像低管电压设置结合个体化对比剂应用的对照研究  

CT pulmonary angiography using 64-row multi-slice spiral CT： a comparative study in low tube voltage setting combined with personalized contrast agent application

作　　者：周旭辉[1] 彭振鹏[1] 郑丽丽[1] 李树荣[1] 杨智云[1] 孟悛非[1] 陈星[1] 

机构地区：[1]中山大学附属第一医院医学放射科,广州510080

出　　处：《中华放射学杂志》2009年第7期704-707,共4页Chinese Journal of Radiology

基　　金：广东省科技计划项目（2006836007007）

摘　　要：目的探讨低kV设置及个体化对比剂应用在64层MSCT肺动脉成像（MSCTPA）中应用的可行性。方法连续选取具有发生肺动脉栓塞可能的高危患者90例，按完全随机设计分为3组：（1）常规组30例，管电压120kV，对比剂总量70ml；（2）120kV组30例，管电压120kV，对比剂总量根据患者体质量进行个体化设置（1．0ml／kg）；（3）100kV组30例，管电压100kV，对比剂总量根据患者体质量进行个体化设置（1．0ml／kg）。3组患者的对比剂均在20S注射完毕，并以相同流率追加生理盐水20ml。对120kV组和100kV组CT图像的客观指标、主观图像质量评价、CT容积剂量指数（CTDIvol）和有效吸收剂量（ERD）进行比较；对100kV组和常规组的对比剂用量、对比剂注射流率、CT图像的客观指标和主观图像质量评价进行比较，以评价64层MSCT低kV没置联合个体化对比剂应用在MSCTPA中应用的可行性。使用方差分析及posthoc检验对3组数据进行统计学分析。结果图像噪声水平：100kV组（5．2±1．8）与120kV组（3．4±0．7）比较增加了52．9％，纵隔窗图像主观图像质量评价差异无统计学意义（q=0．272，P=0．063）；CTDIvol：100kV组[（9．5±0．0）mGy]与120kV组[（14．6±0．0）mGy]比较下降34．9％；ERD：100kV组[（2．4±0．4）mSv]与120kV组[（3．8±0．6）mSv]比较下降36．8％；肺动脉平均CT值：100kV组[（269．2±54．7）HU]相对于120kV组[（237．4±62．9）HU]平均增加了13．4％，与常规组比较差异无统计学意义（q=0．172，P=0．260）。结论64层MSCTPA应用低kV设置（100kV）降低辐射剂量是可行和有效的，个体化对比剂注射方案对特殊人群有一定临床价值。Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row muhi-sliee spiral CT pulmonary angiography. Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design-（ 1 ）Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, （2）Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight（ 1.0 mL/kg）, （3）The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight（1.0 ml/kg）. Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline. The objective and subjective indexes for assessing CT image quality, CT dose index volume （CTDIvol） and effective received dose （ERD） were compared between 120 kV group and 100 kV group; then the contrast media volume,injection rate,objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group. The variance analysis and post hoe test were employed for the statistical analysis. Results Compared with 120 kV group（3.4± 0. 7）, the image quality of 100 kV group（5.2 ± 1.8） had higher noise（52.9% ） , but subjective index for the image quality demonstrated no differences（ q = 0. 272,P = 0. 063 ）in mediastinum window while CTDIvol and ERD decreased for 34. 9% [ （9.5 ± 0. 0） vs （ 14.6 ± 0. 0） mGyl and 36. 8% [ （3.8 ± 0. 6） vs （2. 4 ±0. 4） mSv]. The mean CT values on pulmonary artery of 100 kV group[ （269.2 ±54. 7） HU] were 13.4% （31.8/237.4） higher than the 120 kV group[ （237.4 ± 62. 9）HU ], but there was no statistical differences compared to normal group（q = 0. 172,P = 0. 260）. Conclusion Using low kV setting （100 kV） to reduce radiat

关 键 词：肺动脉 血管造影术 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]