80kVp条件下碘克沙醇(270mgI/mL)应用于冠状动脉CTA检查的可行性研究  

Coronary CT angiography with 80kVp and iodixanol(270mg I/mL) using iterative reconstruction:a feasibility study

作　　者：蒋孟茜[1] 王鹤[1] 王霄英[1] 邹明宇[2] 衣闯[3] 胡刚[4] 王蕊[1] 赵承琳[1] 姜健[1] 张保翠[1] 罗健[1] 高福生[1] 

机构地区：[1]北京大学第一医院影像科,北京100034 [2]沈阳军区总医院,沈阳110016 [3]吉林省人民医院,长春130021 [4]北京军区总医院,北京100700

出　　处：《放射学实践》2014年第3期249-253,共5页Radiologic Practice

摘　　要：目的：探讨在80kVp条件下应用碘克沙醇（270mgI／mL）行冠状动脉CTA检查的可行性，并评估自适应统计迭代重建（ASiR）的应用价值。方法：招募47例受试者行冠状动脉cTA检查。采用前瞻性心电触发扫描模式行冠状动脉CTA扫描，管电压80kVp，管电流600mA。对比剂为碘克沙醇（270mgI／mL），总量60mL。对原始图像的重建采用滤波反投影（FBP）、30％～40％、60％、80％及100％ASiR算法。记录所有患者接受的辐射剂量。由2名心血管系统影像诊断医师分别对冠脉4段主要分支、5组重建图像的诊断信息（冠脉边缘锐利度、斑块与冠脉管腔对比度、图像主观噪声、诊断信心）按5分法进行主观评定，并行统计学分析。将冠脉分为16个节段，测量其CT值及图像背景噪声，并计算图像对比噪声比（CNR）及信噪比（sNR），并进行统计学分析。结果：共37例受试者入组。分析4个血管节段，冠脉图像质量均可达到临床诊断要求，60％及80％ASiR组的诊断信心高于其它各组，且60％ASiR组冠脉边缘锐利度优于80％ASiR组，并在其它细节评估方面不低于其它各组。共分析16个血管节段，冠脉各节段CT值均〉250HU。随AsIR比例的增加，噪声值逐渐下降，CNR、SNR逐渐增高，且各组间差异均有统计学意义。结论：在80kVp条件下应用碘克沙醇270mgI／mL行冠状动脉CTA检查，获得的图像可满足临床需求，推荐使用60％ASiR重建。Objective：To evaluate the image quality of 80kVp coronary CT angiography （CCTA） with 80kVp and contrast of iodixanol （270rag I/mL） using iterative reconstruction. Methods： Forty-seven patients with body mass index （BMI） 20-25kg/m2 were prospectively collected,and underwent prospective ECG-gated CCTA （80kVp,600mA,iodixanol 270mg I/mL,total volume 60mL）. The raw data were reconstructed with filtered back projection （FBP） and 30%-40%, 60 %, 80 %, 100 %adaptive statistical iterative reconstruction （ASiR）, respectively. For subjective assessment, both the o- verall image impression and details of vessel demonstration for each segment were assessed by 2 experienced radiologists. For objective assessment,CT values were measured by segment and the image quality （noise, CNR and SNR） was esti mated. Results：Thirty-seven cases were enrolled. The image quality of CCTA met clinical diagnostic needs, both as whole and as segment. Among the CCTA images with different reconstruction algorithm,images with 60% and 80% ASiR were considered to provide higher diagnostic confidence than others. Comparing with images of 80 % ASiR, the sharpness of coro nary vessel on images of 60G ASiR was better. CNR and SNR were higher in ASiR groups than in FBP group,meanwhile, noise was reduced significantly. Conclusion： To the patients whose BMI 20-25kg/mz, CCTA with 80kVp using iodixanol （270mg I/mL） is feasible for clinical application,and image reconstruction with 60GASiR is recommended.

关 键 词：冠状动脉 体层摄影术 X线计算机 对比剂 迭代重建 辐射剂量 体型特异性剂量估计 

分 类 号：R816.2[医药卫生—放射医学]