光子探测器双源CT70kV联合低对比剂在冠状动脉CTA中的应用  

Application of 70 kV with 30 mL contrast medium by dual-source CT with Stellar photon detector in coronary angiography

作　　者：陈宝锦[1,2] 王锡明[1,2] 程召平[2] 段艳华[2] 齐耀东[2] 康瑞[1,2] 刘文[2,3] 

机构地区：[1]山东大学医学院,山东济南250000 [2]山东省医学影像学研究所 山东省心脑血管疾病诊治重点实验室 [3]泰山医学院

出　　处：《实用放射学杂志》2016年第3期432-436,共5页Journal of Practical Radiology

基　　金：山东省自然科学基金项目（ZR2012HM006）;国家自然科学基金项目（81371547）;泰山学者工程专项经费资助项目.

摘　　要：目的探讨Stellar光子探测器双源CT70kV管电压联合30mL低对比剂前瞻性大螺距扫描在冠状动脉CTA中的应用价值。方法60例体质量指数（BMI〈Q24．9kg／m^2）正常行冠状动脉CTA检查者，随机分为2组（A组：管电压7（）kV、对比剂30mI。；B组：管电压100kV、对比剂50mL），每组30例，2组均采用Stellar光子探测器双源CT前瞻性大螺距螺旋式扫捕技术进行扫描。A组采用SAFIRE迭代重建技术，B组采用滤过反投影（FBP）技术重建；客观评价包括测量CT值、计算信号噪声比（SNR）、对比噪声比（CNR）及记录有效辐射剂量（ED），并用4分法对图像质量评分。组间对比采用独立样本t检验。结果冠状动脉图像质量评分分别为（3．38±0．942）分、（3．50±0．682）分，组间差异无统计学意义（t=-0．562，P〉0．05）；A组患者冠状动脉各节段CT值高于B组（P均〈0．01），2组间SNR、CNR差异无统计学意义（P〉0．05）。A组患者辐射剂量为（O．19±0．023）mSv，B组患者辐射剂量为（0．81±0．101）mSv，A组较B组下降76．5％，差异有统计学意义（P〈0．01）。结论光子探测器双源CT70kV管电压联合30mL低对比剂在正常BMI患者冠状动脉CTA检查中，在获取满足诊断要求图像质量的同时显著降低ED及对比剂用量。Objective To investigate the value of prospectively electrocardiogram （ECG） triggered high pitch coronary computed tomography angiography at 70 kV and 30 mL contrast medium with Stellar detector dual source CT. Methods 60 patients with the BMI〈24.9 kg/m^2 were randomized into two groups：Group A （30 cases） with the tube voltage of 70 kV and 30 mL contrast medi urn. Group B （30 cases） with the tube voltage of 100 kV and 50 mL contrast medium. All the patients were performed with a Stellar detector dual-source CT using a prospectively ECG triggered high pitch spiral technique. The images of C-roup A were reconstructed with SAFIRE technique, while Group B were with FBP technique. The objective image quality includes CT attenuation, SNR, CNR. And radiation dose was also calculated. The subjective was evaluated by 4 scale point. Independent sample t test was used. Resuits There was no difference for subjective image quality between the groups, A： （3.38±0. 942）, B： （3.50±0. 682）, （t= 0. 562, P〉0.05）. The CT attenuation of the 70 kV group were higher than that of the 100 kV group for all the segments（P〈0.01）. The SNR and the CNR have no statistically significant difference between the groups （P〉0.05）. Compared with the 100 kV group, the radiation dose ol the 70 kV group was reduced by 76.5% （A：0.19±0. 023 mSv, B：0.81±0. 101 rosy, P〈0.01}. Conclusion Using 70 kV with 30 mL contrast medium in Stellar detector dual source CT coronary angiography for the patients with a normal BMI could obtain qualified diagnostic image with low radiation dose and contrast medium.

关 键 词：光子探测器 计算机体层成像 冠状动脉成像 辐射剂量 对比剂 

分 类 号：R814.42[医药卫生—影像医学与核医学] R322.121[医药卫生—放射医学]