基于体质指数个性化注射对比剂冠脉CT血管成像的研究  

Individualized injection of contrast agent based on body mass index in coronary CT angiography

作　　者：郭睿 李婷[1] 梁友发[1] 何海波[1] 谭伏平 胡跃群[1] Guo Rui;Li Ting;Liang Youfa;He Haibo;Tan Fuping;Hu Yuequn(Department of Radiology,The Third Xiangya Hospital of Center South University)

机构地区：[1]中南大学湘雅三医院放射科

出　　处：《重庆医科大学学报》2019年第10期1308-1312,共5页Journal of Chongqing Medical University

摘　　要：目的:探讨256排螺旋CT基于体质指数(body mass index,BMI)乘以注射系数对比剂注射方案冠脉CTA成像的可行性。方法:300例有胸痛症状行冠脉CTA成像的患者,随机分成A、B、C 3组。A组,注射速率为0.15×BMI(mL/s);B组,注射速率为0.20×BMI(mL/s);C组,注射速率为0.25×BMI(mL/s),按注射速率×9计算对比剂用量。扫描后主观评估图像质量及测量主动脉根部、左前降支(left anterior descending coronary artery,LAD)、左冠状动脉回旋支(proximal portion of the left circumflex artery,LCX)和右冠状动脉(the right coronary artery,RCA)三支冠脉开口内造影剂浓度。结果:图像质量评价结果显示B组优秀率明显高于另外2组。3组不同方案主动脉及冠状动脉3个主要分支(LAD近端、LCX近端及RCA近端)CT值对比有统计学差异(P<0.001)。而3组方案噪声无统计学差异(P>0.05),其信噪比及对比噪声比依次递增。结论:基于体质量指数乘以注射系数调整对比剂注射速率与用量的冠脉CTA成像方法可以满足临床诊断,并且可以大大降低对比剂的用量。Objective:To investigate the feasibility of a contrast agent injection protocol based on body mass index(BMI)multiplied by injection coefficient in 256-slice spiral computer tomography(CT)for coronary computed tomographic angiography(CTA). Methods:A total of 300 patients with the symptom of chest pain who underwent coronary CTA were randomly divided into groups A,B,and C.The injection rate was 0.15 ×BMI(mL/s) in group A,0.20 ×BMI(mL/s) in group B,and 0.25 ×BMI(mL/s) in group C,and the amount of contrast agent was calculated based on injection rate×9. Image quality was evaluated after scanning,and the concentration of the contrast agent was measured at the root of the aortic valve and at the opening of the left anterior descending coronary artery(LAD),the proximal portion of the left circumflex artery(LCX),and the right coronary artery(RCA). Results:Group B had a significantly higher excellent rate of image quality than the other two groups. There were significant differences between the three groups in the CT values of the aorta and the three important branches of the coronary artery(LAD,LCX,and RCA)(P<0.001). There was no significant difference in noise between the three groups(P>0.05),while signal-to-noise ratio and contrast/noise ratio gradually increased from group A to group C. Conclusion:Injection rate and amount of contrast agent based on BMI multiplied by injection coefficient for coronary CTA can meet the needs of clinical diagnosis and significantly reduce the amount of contrast agent.

关 键 词：体层摄影术 X线计算机 冠状动脉成像 对比剂 

分 类 号：R816.2[医药卫生—放射医学]