个体化对比剂注射方案在常规体质量指数患者冠状动脉CT血管成像中的应用  

Individual contrast medium administration protocol for coronary CT angiography in patients with standard body mass index

作　　者：马燕辉 徐妍妍[1] 孙宏亮[1] 谢晟[1] 王武[1] MA Yanhui;XU Yanyan;SUN Hongliang;XIE Sheng;WANG Wu(Department of Radiology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院放射科,北京100029

出　　处：《实用放射学杂志》2022年第9期1525-1528,共4页Journal of Practical Radiology

基　　金：中日友好医院院级青年课题(2019-1-QN-60);中央高校基本科研业务费项目(3332020077)。

摘　　要：目的探讨基于体质量的个体化注射方案在常规体质量指数(BMI)患者冠状动脉CT血管成像(CCTA)中的可行性.方法将拟行CCTA检查的60例BMI<30 kg/m^(2)患者随机分为试验组与对照组,试验组采用基于体质量的对比剂注射方案:流速(mL/s)=体质量(kg)×0.6(mL/kg)/10 s,对比剂用量=流速×10 s(心率<75次/min);流速×11 s(75次/min≤心率<90次/min);流速×12 s(心率≥90次/min).对照组采用常规固定流速以及对比剂用量(流速5 mL/s,对比剂总量75 mL).由2名放射科医师采用盲法对2组CCTA图像质量进行主观评分(4分制)及客观性测量分析图像噪声、冠状动脉血管密度、信噪比(SNR)、对比噪声比(CNR).采用Mann-Whitney U检验及独立样本t检验比较2组间主观及客观性分析指标.P<0.05为差异有统计学意义.结果2组获取CCTA图像质量均满足临床诊断要求.2组间平均的图像质量得分、SNR、CNR之间均无明显统计差异(P=0.736,P=0.181,P=0.406).2组间图像噪声以及冠状动脉血管密度值(CT冠状动脉)有统计学差异(P<0.001),对照组图像噪声以及CT冠状动脉均明显高于试验组.与对照组相比,试验组单个患者对比剂用量平均减少37.07%.结论基于体质量调整的个体化对比剂注射方案在常规BMI患者中,图像质量优于常规注射方案,在满足临床诊断需求上还可降低对比剂用量,减少患者体内碘负荷.Objective To investigate the feasibility of body weight-adjusted contrast medium administration protocol in coronary CT angiography(CCTA)in patients with standard body mass index(BMI).Methods Totally,60 patients with BMI<3o kg/m?undergoneCCTA were randomly assigned into experimental group and control group.For experimental group,delivered volume and delivery rate of contrast medium were varied according to the following formula:delivery rate(mL/s)=body weight(kg)X 0.6(mL/kg)/10 s,delivered volume=delivery rateX10 s(heart rate<75 beats/min);delivery rateX1l s(75 beats/min≤heart rate<90 beats/min);delivery rateX 12 s(heart rate≥9o beats/min).For control group,delivered volume and delivery rate of contrast medium were fixed with 75 mL at 5 mL/s.Data sets were assessed by two independent observers for image quality(four-point grading score),image noise,attenuation values in coronary arteries,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR).The comparison for those aforementioned parameters between the two groups was done with Mann-Whitney U test or independent-sample t test.P<o.05 was considered statistically significant.Results CCTA images from the aforementioned two groups had diagnostic quality.Mean patient-based image quality scores,SNR and CNR showed no significant difference between the two groups(P=0.736,P=0.181,P=0.406,respectively).Image noise and attenuation values in coronary arteries in control group were both significantly higher than those in experimental group(P<0.001).In addition,dose of contrast medium in experimental group was 37.07%,which was less than that in control group on average.Conclusion The body weight-adjusted contrast medium administration protocol can significantly reduce total iodine dose and individual iodineload while maintaining optimal image quality in CCTA.

关 键 词：冠状动脉CT血管成像 图像质量 体质量指数 对比剂 

分 类 号：R816.2[医药卫生—放射医学] R814.43[医药卫生—临床医学]