应用低管电压扫描降低64排CT冠状动脉成像对比剂用量的研究  

Application of Low Tube Voltage Scan Protocol in Performing Coronary Angiography with 64-Row Spiral CT Scanning for Reducing of Contrast Medium Dosage

作　　者：康德强[1] 赵晶[1] 苗忠[1] 王玲璞[1] 彭楠[1] 华海琴[1] 

机构地区：[1]北京中医药大学东方医院放射科,100078

出　　处：《临床放射学杂志》2014年第5期774-778,共5页Journal of Clinical Radiology

基　　金：北京中医药大学自主选题资助项目(编号:2013041716)

摘　　要：目的在低管电压扫描设置基础上,降低64排CT冠状动脉成像的对比剂用量。方法选取18.0<体质量指数(BMI)≤22.0患者54例,随机分为对照组(A组)10例、低对比剂组(B组)22例、低kV联合低对比剂组(C组)22例。A组采用管电压120 kV,管电流600 mA扫描;对比剂总量65 ml、生理盐水40 ml,注射流率均为5.0ml/s。B组管电压、管电流同A组;对比剂根据体质量采用0.7 ml/kg体重(总量约40 ml)、生理盐水30 ml,注射流率均为4.5 ml/s。C组扫描管电压80 kV,管电流600 mA;对比剂用量、生理盐水用量、注射流率同B组。结果 3组间对比剂用量、主动脉强化峰值、图像噪声、辐射剂量指数、有效剂量间的差异均具有统计学意义(F值分别为420.16、97.51、76.98、305.91、324.21,P值均<0.01),C组较A组对比剂用量下降43.35%,有效剂量下降65.83%;较B组主动脉强化峰值提高81.17%。3组图像评分间的差异具有统计学意义(χ2值为8.29,P值<0.05);C组图像评分优于B组。结论低管电压扫描基础上合理降低对比剂用量,不仅可以显著降低冠状动脉CTA的辐射剂量,而且能够提高造影强化峰值,改善图像质量。Objective To discuss the application of low tube voltage scan protocol in performing coronary angiography with 64-row spiral CT scanning in order to reduce the contrast medium dosage. Methods A total of 54 patients with 18.0 〈 BMI ≤22.0 were randomly divided into group A （ control group, n = 10）, group B （ low contrast medium dosage group, n = 22） and group C （ low tube voltage combined low contrast medium dosage group, n = 22）. In group A, tube voltage of120 kVp, tube current of 600 mA, contrast medium dosage of 65 ml together with 40ml saline and injection flow rate of 5. 0 mlfs were use for CT coronary angiography. In group B, same tube voltage and tube current as in group A, contrast medium dosage of 0.7 mL/Kg together with 30ml saline and injection flow rate of 4.5 ml/s were adopted for CT coronary angi-ography. In group C, tube voltage of 80 kVp, tube current of 600 mA, and the same contrast medium dosage, saline and injection flow rate as in group B were employed. The results were analyzed. Results The contrast medium dosage, attenu- ation values of ascending aorta, image noise, radiation dose index, and effective radiation dosage were determined. The differences between each other among the three groups were statistically significant （F = 420. 16, F = 97.51, F = 76. 98, F=305.91 and F = 324.21 respectively, P 〈 0.01 in all）. In group C the used contrast medium dosage reduced by 43.35% and the radiation dose reduced by 65.83% when compared with those in group A. The peak value of attenuation of aorta was increased by 81.17% in group C when compared with that in group B. The differences in image quality scoreswere statistically significant between each other among the three groups （ X^2 = 8.29, P 〈 0.05 ）. Image quality score of group C was higher than that of group B. Conclusion In performing coronary angiography with 6g-row spiral CT, low tube voltage scan protocol combined with reasonable low dosage of contrast medium can not only significantly reduce the radiation dosage, but

关 键 词：辐射剂量 对比剂 冠状血管造影术 体层摄影术 X线计算机 质量控制 

分 类 号：R816.2[医药卫生—放射医学]