双能量三低扫描在冠状动脉成像中的临床应用研究  

Clinical Application of Double Energy Tri-Low Scanning in Coronary Angiography

作　　者：王栋[1] 常英娟[1] 李剑[1] 曹丽娜 石明国[1] WANG Dong;CHANG Yingjuan;LI Jian;CAO Lina;SHI Mingguo(Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an Shaanxi 710032, China;Department of Radiology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang Shaanxi 712000, China)

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]陕西中医药大学附属医院放射科,陕西咸阳712000

出　　处：《中国医疗设备》2017年第11期1-4,11,共5页China Medical Devices

基　　金：国家自然科学基金(81000648)

摘　　要：目的探讨FLASH双源CT双能量低对比剂量、低对比剂注射流速及低辐射剂量(三低)扫描在冠状动脉成像中的应用。方法选取临床疑似冠心病患者60例随机分为两组,每组30例,分别采用双能量扫描(A组)和常规回顾性扫描(B组)。对比评价两组的图像质量、辐射剂量和最终诊断结果。结果 A组的容积CT剂量指数(CTDIvol)、剂量长度乘积、有效辐射剂量明显低于B组,差异有统计学意义(P<0.05)。A、B两组图像所测右冠状动脉近端、左冠状动脉前降支近端、回旋支近端及升主动脉根部强化值A<B,差异有统计学意义(P<0.05)。所用对比剂量A组小于B组,差异有统计学意义(P<0.05)。A、B两组图像各冠脉近端及升主动脉根部信噪比SNR及对比噪声比CNR无明显差异,无统计学意义。结论冠状动脉CTA成像中双能量扫描可以在同时降低辐射剂量、对比剂剂量、降低注射对比剂的流速(三低)的情况下仍可获得符合临床诊断要求的优质图像,减少对比剂量可降低患者对比剂肾病的发生几率,降低注射流速可降低注射对比剂时皮下外渗的发生几率,在老年患者、糖尿病患者及放化疗患者等体质差人群中可以推广应用。Objective To discuss the application of the dual-energy low contrast dose,low-contrast dose injection and low radiation dose(tri-low)scanning of FLASH dual-source in the application of coronary artery imaging.Methods Sixty patients with suspected coronary heart disease were randomly divided into two groups,with30patients in each group.Dual energy scanning(group A)and routine retrospective scanning(group B)were separately performed on these patients respectively.Image quality,radiation dose and final diagnosis of the two groups were compared.Results The volume CT dose index(CTDIvol)of group A,the product of dose length,the effective radiation dose were significantly lower than group B(P<0.05).The right coronary artery proximal,the anterior descending branch of the left coronary artery,and the proximal and ascending aortic root strengthening value in group A were much lower than that of group B(P<0.05).There was no significant difference in the SNR and the contrast noise between the two groups of images.Conclusion Dual energy scanning(low dose,low contrast medium,low injection rate)can obtain better image in coronary CTA imaging.Reduction of contrast dose can reduce the occurrence of contrast-induced nephropathy.Besides,the low injection velocity is also related to low subcutaneous leakage.Therefore,the dual-energy CT can be widely used in elderly and diabetic patients.

关 键 词：双源CT 双能量 冠状动脉 图像质量 辐射剂量 体层摄影术 

分 类 号：R816.2[医药卫生—放射医学]