宝石CT冠状动脉成像低剂量扫描方案临床应用研究  

Clinical research of dose reduction protocol in coronary artery CT angiography with discovery 750

作　　者：应援宁[1] 张立仁[1] 徐冬生[1] 刘喆[1] 刘军波[1] 管延芳[1] 付东海[1] 周伟[1] 刘艳平[1] 

机构地区：[1]泰达国际心血管病医院放射科,天津300457

出　　处：《中华放射医学与防护杂志》2014年第4期310-313,共4页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的探讨宝石CT心脏冠脉检查中，以患者体重指数（BMI）为基础的低剂量扫描方案实施前后对图像质量及有效辐射剂量的影响。方法连续选取临床拟诊冠心病行CT冠状动脉造影（CTCA）患者207例为A组（实施低剂量扫描方案前一常规剂量组），242例为B组（实施低剂量扫描方案后一低剂量组），根据患者BMI依次选择管电压（kVp）和管电流（mA）。分别对两组患者冠脉图像质量进行评分，比较两组图像的信噪比、容积CT剂量指数（CTDvol）及有效辐射剂量（E），分析扫描变量与患者所接受有效辐射剂量之间的关系。结果A组患者所接受有效辐射剂量为1．9（1．5，2．3）mSv，B组患者所接受有效辐射剂量为1．2（0．8，2．5）mSv（Z=-6．24，P〈0．05）。多因素回归分析显示对有效辐射剂量影响最大的是扫描模式，其次是管电压、管电流、扫描长度。B组冠脉图像信噪比较A组略高（Z=-2．22，P〈0．05）。A组与B组图像质量评分差异无统计学意义。结论低剂量扫描方案可有效降低患者所接受的辐射剂量，并且不影响冠脉图像质量。Objective To evaluate effects on image quality and effective radiation with the dose reduction protocol adapted by body mass index （BMI） in coronary artery CT angiography with discovery 750 HD. Methods Two hundred and seven patients suspected with coronary artery disease （CAD） were enrolled in Group A who were underwent CT angiography with routine radiation, and another 242 patients were enrolled in Group B who received a new scanning protocol with tube voltage and tube current modulation depending on the BMI. The scores of image quality, signal noise ratio （SNR） , CT dose index （CTDIvol） , and effective dose （E） were compared and the correlation between the scanning parameters and E was analyzed. Results The mean radiation dose in Group B （ 1.2, ranging from 0.8 to 2.5 mSv） was significantly lower than that in Group A（ 1.9 ,ranging from 1.5 to 2.3 mSv; Z = - 6.24,P 〈 0. 05 ）. The multivariate regression analysis revealed that the first factor affecting effective radiation dose ranked as scanning mode, tube voltage, tube current, and scan length, respectively. The image quality between two groups was not significantly different. The SNR in Group B was greater than that in Group A （Z = - 2.22, P 〈 0.05）. Conclusions Dose reduction protocol in coronary artery CT angiography with discovery 750 HD would help to reduce the radiation dose effectively without sacrificing image quality.

关 键 词：低剂量 冠状血管造影术 体层摄影术 X射线计算机 

分 类 号：R816.2[医药卫生—放射医学]