“双低”大螺距扫描冠状动脉CT血管成像的临床研究  

Clinical study of high-pitch spiral coronary CT angiography under double low technique

作　　者：戴启春 胡春洪[2] 卢定友 胡粟[2] 闻芳[3] 

机构地区：[1]盐城市第一人民医院CT室,江苏盐城224001 [2]苏州大学附属第一医院影像中心,江苏苏州215006 [3]上海市第十人民医院影像科,上海200072

出　　处：《实用放射学杂志》2017年第11期1773-1777,共5页Journal of Practical Radiology

摘　　要：目的 探讨正常体质量指数（BMI）患者在低管电压、低对比剂（CM）浓度及剂量条件下行双源Flash spiral CT冠状动脉成像的可行性。方法 将90例疑诊冠状动脉疾病且BMI在18.6~25 kg/m^2的患者行冠状动脉CT血管成像（CCTA）检查，随机分为A、B、C 3组，每组30例；CM注射方案：A组碘海醇（350 mg I/mL）、60 mL；B组碘普罗胺（300 mg I/mL）、60 mL；C组碘普罗胺（300 mg I/mL）、45 mL。3组均采用Flash spiral螺旋心脏模式扫描、管电压80 kV及自适应迭代重建算法（SAFIR）。测量主动脉根部、右冠状动脉（RCA）、左冠状动脉前降支（LAD）及左冠状动脉回旋支（LCX）CT值及噪声，计算信噪比（SNR）及对比噪声比（CNR）。采用3分法对所有图像进行主观质量评分。记录有效辐射剂量及总碘摄入量。结果 3组平均有效辐射剂量约0.4 mSv，3组之间差异无统计学意义；总碘摄入量C组（13.5 g）较A组（21 g）降低了35.6%，差异有统计学意义。A组与B组图像噪声、各冠状动脉的SNR、CNR差异均无统计学意义；B组与C组之间各冠状动脉CT值、回旋支的SNR、CNR差异有统计学意义，图像噪声、RCA及LAD的SNR、CNR差异均无统计学意义。3组之间可用于诊断的冠状动脉节段数无统计学差异。结论 对于正常BMI的患者，在80 kV条件下使用碘普罗胺（300 mg I/mL）、45 mL行大螺距CCTA检查可满足临床需求，并能够明显降低辐射剂量和总碘摄入量。Objective To evaluate the feasibility of high-pitch spiral coronary CT angiography （CCTA} under low tube voltage and low contrast agent concentration for the patients with normal body mass index （BMI}.Metbods Ninety patients suspected with coronary artery diseases and with BMI of 18.6--25 kg/m^2 underwent high-pitch CCTA and were randomly divided into three groups （each=30）. Group A used iohexol （350 mg I/mL） 60 mL; Group B used iopromide （300 mg I/mL） 60 mL; Group C used iopro- mide （300 mg I/mL） 45 mL. All of them were scanned under Flash spiral pattern with 80 kV tube voltage, and the original data was calculated with sinogram affirmed iterative reconstruction algorithm（SAFIR）. CT values and noises of the aorta root, right coronary artery （RCA）, left anterior descending artery （LAD）, and left circumflex （LCX） were measured, then signal-to-noise ratio （SNR） and contrast-to-noise ratio （CNR） were calculated. All of images were subjectively assessed by using 3-score method.The effective radiation dose （EDI and total iodine were recorded.Results ED of the three groups were all about 0.4 mSv,and there was no statistically significant.Compared with group A,the total iodine in group C decreased by 35.6 % and there was significant difference.There were no significant differences in image noise,SNR and CNR between group A and group B.Between group B and group C, there were significant differences in CT values of coronary, LCX-SNR and LCX-CNR, but there were no significant differences in image noise,SNR and CNR of RCA and LAD.There was no significant difference in the number of coronary artery segments for diagnosis among the three groups.Conclusion For the patients with normal BMI,application of high-pitch spiral CCTA with iopromide （300 mg I/mL）45 mL under 80 kV tube voltage could meet the requirement for clinical diagnosis,and the radiation dose and total iodine were significantly decreased.

关 键 词：冠状动脉 计算机体层成像 血管造影术 

分 类 号：R322.1[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]