冠脉CTA检查方式对辐射剂量影响的多中心研究  

Multi-center Study on the Relationship between CCTA Examination Modes and Radiation Dose

作　　者：郭道德[1] 李岩[1] 白桦[2] 张挽时[3] 燕树林[4] 金玲[1] 李倩文[1] 王臣[1] 姚新宇[1,5] 杜祥颖[1] 陈楠[1] 李坤成[1,5] 

机构地区：[1]首都医科大学宣武医院,北京100053 [2]中国医学科学院阜外心血管病医院,北京100037 [3]空军总医院,北京100142 [4]首都医科大学附属北京同仁医院,北京100005 [5]北京市卫生局医学影像质量控制与改进中心,北京100053

出　　处：《中国医疗设备》2014年第1期16-18,共3页China Medical Devices

基　　金：首都医学发展科研基金资助(2009:首都医学发展)

摘　　要：目的探讨冠脉CTA检查方式与辐射剂量的关系,以保证检查成功情况下尽可能减少辐射剂量,指导和规范冠脉CTA检查的正当化和最优化。方法分析北京市30家三级医院用于冠脉CTA成像的机型、扫描方式对辐射剂量的影响。根据CT机型和扫描模式进行分组:根据CT机型分成普通64排CT组、后64排CT组两组;按冠脉CTA扫描模式分为前瞻性心电门控序列扫描组、回顾性心电门控螺旋扫描组和单心动周期大螺距扫描组三组,分别统计两组机型及三组扫描方式冠脉CTA检查的CT剂量指数(CTDI)、剂量长度乘积(DLP)和有效剂量(ED),并采用独立样本t检验分别分析不同机型和不同扫描方式辐射剂量的差异。结果后64排CT组的CTDI、DLP、ED三种参数的统计结果分别为(27.61±19.61)mGy、(412.56±328.74)mGy·cm、(5.78±4.60)mSv,均低于普通64排CT组(57.09±27.58)mGy、(950.93±552.91)mGy·cm、(14.53±8.81)mSv,差异有统计学意义(P<0.05)。前瞻性心电门控序列扫描组的CTDI、DLP、ED三种参数的统计结果分别为(17.98±11.27)mGy、(229.63±158.31)mGy·cm、(3.24±2.20)mSv,均低于回顾性心电门控螺旋扫描组(50.89±25.01)mGy、(839.80±469.56)mGy·cm、(12.40±7.42)mSv,差异有统计学意义(P<0.05)。结论使用后64排CT和低剂量扫描模式均可以有效降低冠脉CTA的辐射剂量。Objective This study is to investigate the relationship between different coronary computed tomography angiography （CCTA） examination modes and the radiation dose, in order to achieve as low as reasonable radiation dose, guiding and regulating the legitimation and optimization of coronary CTA examination. Materials and Methods Analyzed the effects of different models of MSCT and different scanning modes for coronary CTA on radiation dose in 30 tertiary hospitals of Beijing. All cases were divided into different groups according to CT models （general 64-slice CT and post 64-slice CT） and scanning modes （prospective ECG-triggering axial acquisition mode, retrospectively ECG-gated spiral data acquisition mode and prospectively ECG-gated high-pitch spiral acquisition mode）. Achieved the mean values of CTDI, DLP and ED respectively and using independent sample t-test to analyze the radiation dose difference between different models and scanning modes. Results The statistical data on CTDI, DLP and ED of the post 64-slice CT is （27.61±19.61） mGy, （412.56±328.74） mGyocm, （5.78±4.60） mSv, respectively, lower than those of the general 64-slice CT （57.09±27.58） mGy, （950.93＋552.91） mGy.cm, （14.53＋8.81） mSv, and the difference was statistically significant （P 〈 0.05）. The mean values of CTDI,DLP and ED were （17.98±11.27） mGy, （229.63±158.31） mGyocm, （3.24±2.20） mSv in the prospective ECG-triggering axial acquisition mode group, retrospectively, while the mean values of CTDI, DLP and ED in ECG-gated spiral data acquisition mode group were （50.89±25.01） mGy, （839.80±469.56） mGy.cm, （12.40±7.42） mSv, respectively, the difference was statistically significant （P 〈 0.05）. Conclusion Post 64-slice CT and low-dose scanning mode are both helpful for radiation dose reduction in coronary CTA.

关 键 词：冠脉CTA 辐射剂量 CTDI DLP ED 

分 类 号：R197.39[医药卫生—卫生事业管理] TH774[医药卫生—公共卫生与预防医学]