100kVp条件下碘克沙醇(270mgI/mL)应用于分次团注双期CTU的可行性研究  

Feasibility study of split-bolus 2-phase CT urography with iodixanol(270mg I/mL)and tube voltage as 100kVp

作　　者：王慧慧[1] 王鹤[1] 王霄英[1] 姜健[1] 高福生[1] 张保翠[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034

出　　处：《放射学实践》2014年第4期373-377,共5页Radiologic Practice

摘　　要：目的：探讨100kVp条件下、碘克沙醇（270mgI／mI。）应用于分次团注CT尿路成像（CTU）的可行性。方法：因血尿待查行CTU检查的连续10例患者行双期团注CTU扫描：管电压采用100kVp，平扫后分2次团注对比剂碘克沙醇（270mgI／mL），第一期剂量为0．6mL／kg，延时10～15min后行第二期团注，剂量为0．9mL／kg，对比剂第2次开始注射后延时100S行肾实质一肾孟期CTU扫描。使用滤波反投影（FBP）及30％、50％、80％和100％（间隔10％）自适应统计迭代重建（ASiR）算法共获得5组CTU图像。记录并计算CTU的体型特异性剂量评估（SSDE）值及有效剂量（ED）。由两位阅片者对2种重建方法共5组图像进行盲法独立阅片，对图像质量进行主观评分。测量各组图像的噪声、尿路各段CT值及对比噪声比（CNR）。结果：本研究中平均对比剂碘摄入量为26．39gi／例。SSDE为（15．38±3．34）mGy，ED为（6．45±1．95）mSv。与FBP图像相比，30％～100％ASiR图像噪声逐渐降低，且差异具有高度统计学意义（P〈0．001），但各组间多数尿路分段CNR的差异无统计学意义（P=0．005～1.000），80％ASiR相对于其它重建方法具有更高的图像质量主观评分。结论：100kVp条件下、碘克沙醇（270mgI／mL）应用于双期团注CTU，可获得符合临床诊断需要的图像，此种条件下推荐使用80％ASiR重建图像。Objective：To evaluate the feasibility of split-bolus 2-phase CT urography （CTU） with Iodixanol （270mg I/mL） and 100kVp technique. Methods：Ten consecutive patients with hematuria undergone CTU were recruited in this study. Split bolus CTU using iodixanol （270rag I/mL） was performed, the tube voltage was 100kVp. After plain CT,Iodixanol was injected with dual bolus. The injection dose of first bolus was 0.6mL/kg,the contrast material of second bolus was injected after 10-15rain, the injection dose was 0.9mL/kg. The renal parenchymal-pelvic phase was taken 100s after the second injection. 5 sets of CTU images were obtained with filtered back projection （FBP） and 30% ,50%,80% and 100% adaptive statistical iterative reconstruction （ASiR）. The size-specific close estimate （SSDE） and effective dose （ED） were recorded and calculated. Scores were assigned by two qualified readers double-blindly to evaluate the image quality with different reconstruction algorithm. The CT values,image noise, and CNR of different segments of renal collection system were measured respectively. Results：The mean iodine intake of contrast material was 26. 39g I per person. The mean radiation dose was （15.38± 3.34）mGy for SSDE and （6.45 ±1.95）rosy for ED. Compared with FBP images, the image noise reduced gradually from 30% to 100% ASiR,with statistic significance （P〈0. 001）. No statistic significance was existed in the CNR of different segments of collective system （P=0. 005-1. 000）. The subjective image quality score was the highest in 80% ASiR. Conclusion： Application of iodixanol （270mg I/mL） split-bolus 2-phase CTU using tube voltage as 100kVp can meet clinical need with good enough image quality,and 80%ASiR reconstruction is recommended.

关 键 词：体层摄影术 X线计算机 泌尿系成像 对比剂 迭代重建 辐射量 体型特异性剂量估计 

分 类 号：R816.7[医药卫生—放射医学]