双源CT低辐射剂量冠状动脉成像的初步研究  

A Preliminary Study on Low Radiation Dose Dual-source CT Coronary Angiography

作　　者：胡永胜[1] 朱有志[2] 何新华[1] 王自勇[1] 胡勤衍[2] 付璇[1] 王慧[1] 费长军[1] 王劲武[1] 

机构地区：[1]合肥市第一人民医院影像中心 [2]中国人民解放军第105医院放射科

出　　处：《中国医学计算机成像杂志》2012年第2期122-127,共6页Chinese Computed Medical Imaging

摘　　要：目的：探讨双源CT（DSCT）低剂量冠状动脉成像在较大体重质量指数（BMI）范围中的临床应用价值。方法：将BMI在17.51~30.00之间的可疑冠心病患者随机分为两组：A组（低辐射剂量组）95例,依据体重指数再将其分为三组（BMI〈18.5,18.5≤BMI〈24和24≤BMI）,采用100kVp,参考毫安320mAs扫描;B组（常规辐射剂量组）69例,采用120kVp,参考毫安360mAs扫描,其他参数两组相同。两组均使用回顾性心电门控和CareDose4D技术进行DSCT（Somatom Definition,西门子）冠状动脉成像增强检查,检查前均不使用受体阻滞剂控制心率。所有扫描数据传送到西门子独立图像后处理工作站进行进一步处理。分析A、B两组最佳的重建时相图像,由2名副主任医师独立评估图像质量。记录并计算CT容积剂量指数（CTDIvol）、剂量长度乘积（DLP）及有效剂量（ED）值。利用单因素方差分析比较A组中三组图像质量是否存在差别。应用χ^2检验比较A、B两组患者冠状动脉分级显示段数,应用两独立样本t检验比较A、B两组患者图像质量评分、CTDIvol、DLP和ED等。结果：A组中的三组图像评分为4.67±0.53、4.72±0.42、4.51±0.57;三组图像质量评分差异无统计学意义（F=1.39,P=0.25）。A组评价1298段冠状动脉,B组评价934段冠状动脉。图像质量评为优良的A组占99.31%,B组占99.79%,两组显示差异无统计学意义（χ^2=2.54,P=0.11）;可诊断图像节段数A组占99.69%,B组占99.89%,两组显示差异无统计学意义（χ^2=0.98,P=0.32）。A、B两组图像质量评分分别为4.69±0.47、4.81±0.35分;CTDIvol值分别为18.53±7.55、45.85±15.49;DLP值分别为253.31±97.78、645.10±254.00;ED值分别为4.31±1.66、10.97±4.32。A、B两组间的图像质量评分差异无统计学意义（t=-1.70,P=0.09）,A、B两组CTDIvol差异有统计学意义（t=-14.93,P=0）,A组小于B组;A、B两组间DLP差异有统计学意义（t=-13.71,P=0）,A组小于B组,APurpose： To evaluate the clinical value of low radiation dose dual-source CT coronary angiography in a large range of body mass index（BMI）.Methods： All patients（BMI 17.51~30.00） who were suspected with coronary artery diseases were randomly divided into two groups： group A（low radiation dose group） with 95 cases and group B（conventional radiation dose group） with 69 cases.And group A was divided it into three subgroups according to their BMI（BMI〈18.5,18.5≤BMI〈24 and 24≤BMI）.The scan parameters for group A were 100kVp,320mAs and 120kVp,360mAs for group B,other parameters between groups were the same.Both groups were using retrospective ECG gating and CareDose 4D technology DSCT（Somatom Definition,Siemens） coronary angiography,no beta-blockers were taken before CT scan to control heart rate.All image data were transferred to the Siemens independent image post-processing workstation for further processing.Two experienced associate chief physicians assessed the quality of the reconstructed images of these two groups independently.The CT volume dosage index（CTDIvol）,dose length product（DLP）and effective dose（ED）were recorded.One-way analysis of variance was used to compare the image quality of the three subgroups of group A.The scores of the imaging quality grading of coronary artery segments were compared by Chi-square test,2 samples t test was used to compare the image quality score,CTDIvol,DLP and ED between the two groups of patients.Results： The image quality scores of the three subgroups in group A were 4.67±0.53,4.72±0.42 and 4.51±0.57 respectively,and there was no significant difference between the three subgroups（F=1.39,P=0.25）.A total of 1298 coronary artery segments were evaluated in group A and 934 segments were evaluated in group B.Hi-quality and well segments were accounted for 99.31% in group A,accounted for 99.79% in group B.There was no statistical difference between the two groups（χ^2 =2.54,P=0.11）.The diagnosable segments were accounted

关 键 词：冠状血管 体层摄影术 X线计算机 辐射剂量 

分 类 号：R816.2[医药卫生—放射医学]