低浓度对比剂联合低电压和迭代重建算法在320排CT冠状动脉成像中的应用  

Application of low concentration contrast medium in combination with low tube voltageand iterative reconstruction algorithm in 320 row coronary CT angiography

作　　者：梁奕 杜柏林 汪汉林 李贞 石敏 周杰 

机构地区：[1]长江航运总医院武汉脑科医院影像科,湖北武汉430010

出　　处：《实用放射学杂志》2016年第1期114-117,共4页Journal of Practical Radiology

摘　　要：目的 探讨低浓度对比剂联合低电压和迭代重建算法行320排CT冠状动脉成像的可行性。方法 选取心率≤70次/min、心律规则的60例患者，随机分为A、B 2组，各30 例，A组管电压120 kVp，370 mg I/mL对比剂，滤波反投影算法（FBP）重建；B组管电压100 kVp，270 mg I/mL对比剂，自适应迭代剂量减低算法（AIDR 3D）重建。采用双盲法评价2组间冠状动脉各节段图像质量的差异,比较2组兴趣区增强CT值、噪声（SD）、信噪比（SNR）、对比噪声比（CNR）、剂量长度乘积（DLP）和有效辐射剂量（ED）的差异。结果 60例检查成功率为100%。注射对比剂时患者有明显热感者B组（4/30）明显低于A组（25/30）。主观评价2组间可诊断的节段差异无统计学意义（P＞0.05）。2组兴趣区增强CT值差异无统计学意义，但SD、SNR以及CNR均有显著差异（P＜0.05）。2组间DLP和ED差异有统计学意义（P＜0.05），B组较A组降低约50%。结论 采用低浓度对比剂（270 mg I/mL）联合低电压（100 kVp）和迭代重建算法（AIDR 3D）在320排CT冠状动脉血管成像中能获得满意的诊断图像，且患者舒适度好，并能有效降低辐射剂量。Objective To investigate the feasibility of low concentration contrast medium in combination with low tube voltage and iterative reconstruction algorithm in 320 row coronary CT angiography. Methods 60 patients with heart rate ≤70 beats per mi nute and normal cardiac rhythm were divided randomly into two groups with 30 patients respectively. Patients in group A received CTA scan with 120 kVp and 370 mg I/mL of contrast media in combination with FBP （filtered back-projection）, meanwhile patients in group B with 100 kVp and 270 mg I/mL of contrast media in combination with adaptive iterative dose reduction （AIDR 3D）. Two observes independently assessed the image quality of each coronary segment using double blinded method. The CT values,standard deviation（SD）,signal to noise ratio （SNR）,contrast to noise ratio {CNR）,doses length product （DLP） and effective dose （ED） were studied by statistical analysis. Results These exams were performed successfully. The sense of warmth of patients in group B （4/30） was significantly lower than that in group A （25/30）. The difference in evaluation of the segments with different grades was not statistically significant （P〉0.05）. The difference in vascular enhanced CT value was not statistically significant, however the SD,SNR and CNR were significantly different （P〈0.05）. The difference in the radiation dose between the two groups was also statistical signifi cance （P〈0.05） ,and the close of group B was lower by 50% than that in group A. Conclusion With low concentration of contrast medium （270 mg I/ml）,low voltage （100 kVp） in combination with the iterative reconstruction algorithm （AIDR 3D）,320 row CT is feasible in imaging the coronary arteries with satisfied image quality, more comfortability and reduced radiation dose.

关 键 词：计算机体层成像 血管造影术 对比剂 辐射剂量 迭代重建 

分 类 号：R814.42[医药卫生—影像医学与核医学] R322.1[医药卫生—放射医学]