冠状动脉CT血管成像中低管电压结合低流速造影剂注射的可行性分析  

Low tube voltage combined with low flow rate injection of contrast medium for coronary CT angiography

作　　者：邓亮 王梦莉 Deng Liang;Wang Mengli(Department of Radiology ^Yichang First People's Hospital,Yichang 443000,Hubei Province,China)

机构地区：[1]三峡大学人民医院宜昌市第一人民医院放射科

出　　处：《中华老年心脑血管病杂志》2019年第10期1012-1015,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨冠状动脉CT血管成像(CTA)中应用低管电压结合低流速造影剂注射的可行性。方法前瞻性连续入选放射科行冠状动脉CTA检查的有症状疑诊冠心病患者446例,根据排除标准最终纳入患者420例,随机分为试验组210例(管电压100kVp,流速4ml/s),对照组210例(管电压120kVp,流速6ml/s)。比较2组患血管强化的CT值、信噪比、对比度噪声比、图像质量主观评分以及造影剂外渗发生率。结果试验组与对照组图像质量评分分别为(4.0±0.9)分及(4.1±0.9)分,差异无统计学意义(P>0.05)。试验组与对照组升主动脉、左前降支及右冠状动脉平均CT值、图像噪声、信噪比及对比度噪声比比较,差异无统计学意义(P>0.05)。试验组CT容积剂量指数、剂量长度乘积和有效辐射剂量明显低于对照组[(20.5±8.4)mGy vs (31.4±10.1)mGy,251.7±21.5 vs 324.5±20.7,(3.5±1.1)mGy vs (4.5±1.6)mGy,P<0.01]。试验组造影剂外渗1例(0.5%),对照组造影剂外渗10例(4.8%),差异有统计学意义(P=0.011)。结论低管电压联合低流速造影剂与高管电压联合高流速造影剂冠状动脉CTA图像质量无差异,但低流速降低造影剂外渗的风险,同时有效降低辐射剂量。Objective To study the low tube voltage combined with low flow rate injection of contrast medium(CM)for CCTA.Methods Four hundred and twenty CHD patients who underwent CCTA were divided into experimental group(n=210)and control group(n=210).The patients in experimental group underwent CCTA with 100 kVp tube vottage,4 ml/s flow rate and those in control group underwent CCTA with 120 kVp tube vottage,6 ml/s flow rate.The blood vesselintensified CT values,signal/noise ratio(SNR),contrast/noise ratio(CNR),subjective score of image quality,and incidence of CM extravasation were compared between the two groups.Results No significant difference was detected in subjective score of image quality(4.0±0.9 vs 4.1±0.9,P>0.05)and in CT values of ascending aorta,left anterior descending branch and right coronary artery,image/noise ratio,SNR and CNR between the two groups(P>0.05).The CT volume dose index,dose-length product and effective radiation dose were significantly lower in experimental group than in control group(20.5±8.4 mGy vs 31.4±10.1 mGy,251.7±21.5 vs 324.5±20.7,3.5±1.1 mGy vs 4.5±1.6 mGy,P<0.01).CM extravasation was detected in 1 patient(0.5%)of experimental group and in 10 patients(4.8%)of control group(P=0.011).Conclusion No significant difference is detected in image quality of CCTA between low tube voltage combined with low and high flow rate injection of CM.However,low flow rate injection of CM can effectively reduce the risk of CM extravasation and the radiation dose of CCTA.

关 键 词：冠状动脉疾病 体层摄影术 X线计算机 造影剂 诊断和治疗物质外渗 

分 类 号：R816.2[医药卫生—放射医学]