前瞻性心电门控结合迭代重建技术在降低冠状动脉CTA的辐射剂量及对比剂用量中的可行性研究  

Feasibility Study of Prospective ECG-gating Combined with Iterative Reconstruction in Reducing the Radiation Dose and Contrast Dose of Coronary Artery CTA

作　　者：叶红[1] 黄小茹[1] 黄朝南[1] 潘海锋[1] 温丹娜 吴驰[1] Ye Hong;Huang Xiaoru;Huang Chaonan;Pan Haifeng;Wen Danna;Wu Chi(Department of Radiology, Guangdong Nongken Central Hospital, Zhanjiang 524002)

机构地区：[1]广东省农垦中心医院放射科,广东湛江524002

出　　处：《现代医用影像学》2019年第6期1204-1208,共5页Modern Medical Imageology

基　　金：广东省湛江市非资助科技攻关计划项目(项目编号:2016B01018)

摘　　要：目的:探讨前瞻性心电门控结合迭代重建技术在降低冠状动脉多层螺旋CT血管成像(MSCTA)辐射剂量及对比剂用量中的价值。方法:将234例符合纳入标准疑似冠状动脉性心脏病病人,随机分为A、B两组,采用不同的扫描及碘对比剂注射方案进行冠脉MSCTA,实验组(A组)采用管电压100kV,碘对比剂注射速率4.5ml/s,前瞻性心电门控,图像采用迭代法重建。对照组(B组)管电压为120kV,对比剂注射速率5.0ml/s,回顾性心电门控,图像采用滤波反投影法重建。两组管电流均为160 mAs。对MSCTA图像采用主观4分法进行评价,并测量两组的图像噪声,计算辐射有效剂量。结果:A组117例,男67例、女50例;年龄32～86岁,平均(58.40±10.93)岁;体重指数22.03±1.71(kg/m^2)。B组117例,男76例、女41例;年龄35～85岁,平均(59.32±9.97)岁;体重指数22.04±1.79(kg/m^2)。A、B两组辐射剂量分别为(1.15±0.29)mSv、(4.24±1.23)mSv;对比剂碘含量分别为(18.44±0.88)gI和(23.78±0.86)gI。A组辐射剂量和对比剂碘含量均低于B组,两组差异有统计学意义(P<0.05);两组的图像噪声及图像评分差异无统计学意义(P>0.05)。结论:前瞻性心电门控加迭代重建检查技术应用于MSCTA,在获得满足诊断需要的冠状动脉图像的情况下,能降低冠状动脉的辐射剂量及对比剂用量。Objective:To explore the value of prospective ECG-gating combined with iterative reconstruction in reducing the radiation dose and contrast agent dosage of multi-slice spiral CT angiography(MSCTA) in coronary artery.Methods:234 patients with suspected coronary heart disease who met the inclusion criteria were randomly divided into group A and group B, and coronary MSCTA was performed using different scanning and iodine contrast injection schemes. In the experimental group(group A), tube voltage was 100 kV, iodine contrast injection rate was 4.5 ml/s, prospective ECG-gating contro and the image was reconstructed by iterative method. While the control group(group B) tube voltage of was 120 kV, iodine contrast injection rate was 5.0 ml/s, retrospective ecg contro and the image was reconstructed by filtering back projection method. Both groups have the same current of 160 mAs.The MSCTA images were evaluated by the subjective 4-point method, and the image noise of the two groups was measured, and the radiation effective dose was calculated.Results:There were 117 cases in group A, 67 male and 50 female;Age: 32~86, mean(58.40 ±10.93);Body mass index 22.03±1.71(kg/m^2), 117 cases in group B, 76 male and 41 female;Age: 35~85, mean(59.32 ± 9.97);Body mass index22.04±1.79(kg/m^2).The radiation doses of group A were(1.15 + 0.29) mSv, and group B were(4.24 + 1.23) mSv. The contrast iodine content of group A were(18.44±0.88)gI and group B were(23.78±0.86)gI.The total dose of radiation and contrast iodine content in group A was lower than that in group B(P<0.05), and the difference between the two groups was statistically significant. There was no significant difference in image noise and image score between the two groups(P>0.05).Conclusion:Prospective ECG-gating combined with iterative reconstruction technique applied to multi-slice spiral CT angiography(MSCTA)can reduce the radiation dose and contrast dose of coronary artery when the quality of coronary artery images meets the diagnostic needs.

关 键 词：体层摄影 冠状动脉 心电门控 迭代重建 低剂量 

分 类 号：R816.2[医药卫生—放射医学] R541.4[医药卫生—临床医学]