低管电压结合低剂量碘克沙醇在老年患者肾动脉CT成像中的应用  

The applying of a low tube voltage combined with low dose of iodixanol to renal artery CT imaging in elderly patients

作　　者：程村委 郭君武 

机构地区：[1]郑州大荤第二附属医院放射科,450014

出　　处：《中华老年医学杂志》2018年第3期272-275,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨80kVp管电压结合低剂量低浓度对比剂在老年患者肾动脉CT血管成像（CTA）中的应用。方法2016年8月至2017年6月在我院行肾动脉或腹主动脉CTA检查的老年患者160例，数字抽签分为常规组：管电压120kVp，管电流120mAs，对比剂70ml；管电压（80kVp）、对比剂（50m1）双低患者根据管电流强度不同分为：双低（150mAs）组、双低（180mAs）组、双低（210mAs）组（各40例）。测量经原始数据的迭代重建（SAFIRE）后各组肾动脉水平腹主动脉、双侧肾动脉及其分支的CT值、图像噪声并计算信号噪声比（SNR）、对比噪声比（CNR）及有效辐射剂量等，不良反应发生率；采用5分法评估图像质量。结果双低3组血管强化程度高于常规组（均P〈0．05），双低3组噪声高于常规组（P〉0．05），常规组与双低（210mAs）组比较，SNR、CNR差异无统计学意义（均P〉0．05），双低（150mAs）组、双低（180mAs）组SNR、CNR低于常规组（均P〉0．05）；双低（150mAs）组、双低（180mAs）组、双低（210mAs）组有效辐射较常规组分别下降63．3％、56．2％、48．8％；各组图像评分均大于3分。常规组4例轻度对比剂不适反应，双低3组均未出现不良反应。结论80kVp管电压低剂量低浓度对比剂条件下适当提高管电流，结合SAFIRE迭代重建技术既能保证图像质量，又能降低辐射剂量和对比剂引起的器官损害，具有临床应用价值。Objective To explore the clinical application of 80 kVp tube voltage combined with low dose and low concentration contrast agent in CT imaging of renal artery （CTA） in elderly patients. Methods 160 elderly patients undergoing CT angiography of renal artery or abdominal aorta in our hospital from August 2016 to June 2017 were randomized to control group （routine-dose CT with 120 kVp at 120 mAs, contrast agent of 70 ml, n=40） and double low group （X-ray tube voltage at 80 kVp and contrast agent of 50 ml）, which was re-divided to double low-150 mAs group, double low-180 mAs group, and double low-210 mAs group （n=40, each）. The CT value of bilateral renal arteries, their branches, and abdominal aorta at the same height of renal artery, signal to noise ratio （SNR）, contrast to noise ratio （CNR）, the effective radiation dose, and the incidence of adverse reaction were measured after sinogram=affirmed iterative reconstruction （SAFIRE）. And the image quality was evaluated and rated on a scale from 1 to 5 by two independent qualified radiologists. Results The vascular enhancement was significantly higher in the three double low groups than in the control group （all P〈0.05）. Noise level was higher in the three double low groups than in the control group （all P〈0. 05）. SNR and CNR showed no significant difference between the double low-210 mAs group and the control group （P〉 0.05）, while statistical differences were found in SNR and CNR in the control group versus double low-150 mAs and double low-180 mAs groups （all P〈0.05）. As compared with the control group, effective radiation dose was decreased in the three double low groups by63.3% （150 mAs）, 56.2% （180 mAs）, 48.8% （210 mAs）, respectively. All image scores in four groups were over 3 points. Mild adverse effects were observed in four cases from the control group, and no adverse effect occurred in the other three groups. Conclusions 80 kVp tube voltage combined with low dose and low concentration contrast a

关 键 词：体层摄影术 X线计算机 造影剂 肾动脉成像 

分 类 号：R816[医药卫生—放射医学]