低管电压扫描条件下个体化对比剂用量方案在冠状动脉CTA中的应用  

Individualized contrast medium protocol in 64-row multi-slice spiral CT coronary angiography with low scan tube voltage

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

机构地区：[1]北京中医药大学东方医院放射科,北京100078

出　　处：《中国介入影像与治疗学》2014年第9期616-620,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：北京中医药大学自主选题资助项目(2013041716)

摘　　要：目的探讨冠状动脉CTA中以体质量指数（BMI）与体表面积（Suf）作为个体化分类标准,联合100kV低管电压扫描,降低对比剂用量、提高造影效率和图像质量的价值。方法入组患者17.0≤BMI〈26.5,分为120kV组（A组）与100kV组（B组）,各100例。A组扫描管电压120kV,管电流600mA;对比剂0.8-1.0ml/kg（总量约65ml）,生理盐水50ml,注射流率均为5.0ml/s。A组检查完毕后采用线性回归分析对比剂用量与BMI、Suf关系,制成量化速查表。B组扫描管电压100kV,管电流600mA;对比剂根据上述速查表采用35-65ml,生理盐水30-50ml（对比剂总量×80%）,注射流率均为5.0ml/s。结果两组对比剂用量、主动脉强化值、左心室强化值、图像噪声、辐射剂量指数、有效剂量差异均有统计学意义（P均〈0.05）,B组较A组对比剂用量下降28.16%、主动脉强化值提高21.58%;辐射剂量指数下降39.54%、有效剂量下降40.83%、噪声值升高27.15%。两组图像质量评分B组优于A组（P〈0.01）。结论以BMI、Suf作为个体化分类标准,可降低检查中对比剂用量、提高造影效率;结合100kV低管电压扫描,能在显著降低辐射剂量的同时改善图像质量。Objective To explore the value of reducing contrast medium usage, improving coronary CTA efficiency and improving image quality in 64-row CT coronary angiography with 100 kVp scan tube voltage taking body mass index （BMI） combined body surface （Suf） as a new standard protocol. Methods Patients with 17.0≤BMI≤26.5 were divided to control group （group A, n= 100） and individualized group （group B, n= 100） randomly. Patients in group A were examined with tube voltage of 120 kVp and tube current of 600 mA. The contrast medium （CM） dosage was 0.8--1.0 ml/kg accord- ing to their body weight （about 65 ml in total）, saline usage was 50 ml, and injection flow rate was 5.0 ml/s. When all the examinations were finished in group A, a linear regression was used to analyze the correlation between CM dosage and BMI, Suf. The result was used to formula a regression equation. Another 100 patients in group B underwent individualized coronary CTA with tube voltage of 100 kVp and current of 600 mA, CM dosage was variable according to the data in the table list, being 35--65 ml of CM and 30 50 ml of saline （CMX 80%）, and injection flow rate was 5.0 ml/s. Results The CM dosage, attenuation values in ascending aorta and left ventricle, image noise, volume CT dose index （CTDIvol）, and radiation dosage had significantly differences between the two groups （all P〈0.05） . The contrast medium usage reduced by 28.16%, aorta attenuation inereased by 21.58%, CTDIvol reduced by 39.54%, radiation dosage reduced by 40.83%, and image noise inereasedby 27.15% in group B compared with group A. The image score also had significantly differenee between the two groups （P〈0.01）. Better seore performance obtained in group B than group A （P〈 0.01）. Conclusion Lower usage of CM and better angiography performanees are obtained using BMI combined Suf as a new protocol in individualized coronary CTA examination. Also low radiation dosage .and fine image quality achieve when 100 kVp scan protocol is used at th

关 键 词：对比剂 血管造影术 体层摄影术 X线计算机 辐射剂量 

分 类 号：R816.2[医药卫生—放射医学] R541.4[医药卫生—临床医学]