双源CT大螺距、低管电压扫描联合迭代重建技术在经导管主动脉瓣置换术术前评估中的应用价值  

Dual-source CT with high-pitch, low tube voltage and iterative reconstruction in preoperativeevaluation of transcatheter aortic valve replacement

作　　者：严辉峰 张丽[2] 张照涛 姚彬[1] 刘颖[1] 左敏静[1] 李晓[1] 黄水平[1] 

机构地区：[1]南昌大学第二附属医院CT室,330006 [2]南昌大学第二附属医院神经内科,330006

出　　处：《中华放射医学与防护杂志》2017年第2期149-154,共6页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 探讨双源CT大螺距、低管电压（kV）扫描联合迭代重建技术在经导管主动脉瓣置换术（TAVR）术前评估中的应用价值。方法 顺序入组疑主动脉瓣狭窄的60例患者行胸腹主动脉CT血管成像（CTA）检查，按随机数字表法分成大螺距扫描组、联合低kV＋迭代重建组和常规扫描组，每组各20例，分别对3组主客观图像质量、对比剂用量及辐射剂量进行对比分析。结果 主观图像质量评分常规扫描组仅3例符合TAVR术前评估要求，大螺距扫描、联合低kV＋迭代重建组均明显高于常规扫描组（t=17.083、16.667，P〈0.05），但大螺距扫描组与联合低kV＋迭代重建组间差异无统计学意义（P〉0.05）；3组间客观图像质量参数信噪比（SNR）、对比噪声比（CNR）差异均无统计学意义（P〉0.05）；对比剂用量大螺距扫描、联合低kV＋迭代重建组明显低于常规扫描组（t=-13.645、-14.647，P〈0.05），但大螺距扫描、联合低kV＋迭代重建组间差异无统计学意义（P〉0.05）；辐射剂量参数容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）及有效剂量（E）值，联合低kV＋迭代重建组均明显低于大螺距扫描、常规扫描组，且3组间差异均存在统计学意义（F=2 564.398、651.616、653.308，P〈0.05）。结论 双源CT大螺距、低kV扫描联合迭代重建技术的图像质量能满足TAVR术前评估，同时可大大降低辐射剂量及对比剂用量。Objective To investigate the value of Dual-source CT with low tube voltage（kV）, high-pitch, and iterative reconstruction in preoperative evaluation of transcatheter aortic valve replacement（TAVR）.Methods Sixty patients with suspected aortic stenosis who underwent thoraco-abdominal CT angiography （CTA） were divided into three groups （n=20） using a table of random numbers method （simple high-pitch group, combined high-pitch, low-kV and iterative reconstruction group and conventional group）. Subjective and objective scores of image quality, contrast dosage and radiation dose of three groups were compared. Results The subjective scores of image quality were seen in only three cases in conventional group which met preoperative assessment of TAVR, and were significantly higher in high-pitch group and combined group than those in conventional group（t=17.083,16.667,P〈0.05） with no statistically significant difference（P〉0.05） between high-pitch group and combined group. There was no statistical significance among three groups about the objective evaluation of image quality. The dosage contrast medium in high-pitch group and combined group were significantly less than that in conventional group （t=-13.645,-14.647,P〈0.05）, but there was not statistically difference （P〉0.05） between high-pitch group and combined group. The volume CT dose index（CTDIvol）, dose length product （DLP） and the effective dose（E） values of combined group were significantly lower than those in high-pitch group and conventional group, and there were statistically different among three groups（F=2 564.398,651.616,653.308,P〈0.05）. Conclusions The Dual-source CT with low tube voltage, high-pitch and iterative reconstruction could meet the requirement of image quality for preoperative assessment of TAVR, and greatly reduce the dose of radiation and contrast medium.

关 键 词：双源CT 大螺距 低管电压 迭代重建 经导管主动脉瓣置换术(TAVR) 

分 类 号：R654.2[医药卫生—外科学]