采用低管电压联合低浓度对比剂方案行头颈CT血管成像的可行性  

The feasibility of the applications of dual-low-dose with low tube voltage for head and neck CT angiography

作　　者：王海林[1] 兰茜琳[2] 纪建松[1] 鲁思明 陈敏江[1] 卢陈英[1] 胡祥华[1] 刘伟文[1] 陈春妙 吴徐璐 

机构地区：[1]浙江省丽水市中心医院放射科,323000 [2] 温州医科大学附属第五医院放射科

出　　处：《中华放射学杂志》2017年第5期382-385,共4页Chinese Journal of Radiology

基　　金：丽水市科技白筹项目（2014ze006）

摘　　要：目的 探讨采用低管电压联合低浓度对比剂方案行头颈CTA的可行性.方法 前瞻性连续收集临床拟行头颈部动脉CTA检查且体质量指数（BMI）＆lt;25 kg/m^2的患者纳入研究.常规组患者40例;低剂量组120例,低剂量组再根据随机数字表法分为低碘组（37例）、低管电压组（42例）和双低组（41例）3个亚组.各组患者均行头颈部CTA检查.常规组的管电压、管电流和对比剂浓度分别为120 kV、150 mAs、含碘320 mg/ml;低碘组分别为120 kV、150 mAs、含碘270 mg/ml;低管电压组分别为100 kV、150 mAs、含碘320 mg/ml;双低组分别为100 kV、150 mAs、含碘270 mg/ml.各组的对比剂剂量均为0.9 ml/kg,流率均为4.5 ml/s.对各组图像质量进行评分,测量颈动脉分叉的CT值和信噪比,记录各组患者的碘摄入量和有效辐射剂量（ED）.采用非参数秩和检验或单因素方差分析比较4组间上述指标的差异.结果 常规组和低剂量组（低碘组、低管电压组、双低组）图像质量均较好,4组间评分的差异无统计学意义（P＆gt;0.05）,各组图像均达到诊断要求.4组患者间的CT值、信噪比、碘摄入量和ED差异均有统计学意义（P均〈0.05）,其中双低组的CT值高于常规组、低碘组,低于低管电压组;双低组与常规组的信噪比高于低碘组和低管电压组;双低组与低碘组的碘摄入量低于常规组和低管电压组;双低组和低管电压组的ED低于常规组和低碘组,差异均有统计学意义（P〈0.05）.结论 采用低管电压联合低浓度对比剂方案行头颈部CTA具有可行性,在不降低图像质量的前提下,可以有效减低碘摄入量和辐射剂量.Objective To explore the clinical value of the dual-low-dose with low tube voltage for head and neck CTA. Methods One hundred and sixty patients who were clinically suspected head and neck vascular disease underwent CTA procedure were propective selected, and whose body mass index （BMI） was also lower than 25 kg/m^2. Forty cases were randomly selected as conventional group（120 kV,150 mAs, iodine 320 mg/ml）, the other 120 cases were as the low dose group. The low dose group divided into three subgroups according to the random number table method, which were low iodine group （37 cases;120 kV,150 mAs, iodine 270 mg/ml）, low tube voltage group （42 cases;100 kV,150 mAs, iodine 320 mg/ml） and low iodine and tube voltage group （41 cases;100 kV,150 mAs, iodine 270 mg/ml）. The carotid bifurcated CT value, standard deviation （SD）, signal-to-noise ratio （SNR）, iodine intake and effective radiation dose （ED） of the four groups were recorded,all data undertook statistical analysis useing one-way ANOVA. Meanwhile, the subjective image quality score was applied to evaluate the image quality, and the differences among groups were compared by Wilcoxon signed ranks test. Results The image quality score were （2.85±0.19）,（2.33 ±0.34）,（2.26 ± 0.32）,（2.87 ± 0.22） in the four groups, and there was no statistical difference between groups（P＆gt;0.05）.The carotid bifurcated CT value were respectively （380±30）,（314±27）,（514±52） and （425±28） HU in conventional, low iodine, low tube voltage and dual-low-dose groups, and the iodine intake were （18.85±2.10）, （15.75±1.78）, （18.53±1.98）, （15.62±1.92） g, the ED of the four groups were （1.74±0.14）, （1.73± 0.11）, （1.32 ± 0.08） and （1.35 ± 0.09） mSv, the difference were all statistically significant （P〈0.01）. Furthermore, the iodine intake and the effective radiation dose in dual-low-dose group were significantly lower than the conventational group. Conclusions Head-and-neck CT

关 键 词：体层摄影术 X线计算机 辐射剂量 对比研究 

分 类 号：R816.1[医药卫生—放射医学]