冠状动脉CT血管成像100 kVp碘流率降低至120 kVp水平60%的可行性分析  

Feasibility analysis on reducing iodine delivery rate of coronary CT angiography with 100 kVp to 60%of 120 kVp standard

作　　者：王莹[1] 狄爱辉 张艳[1] Wang Ying;Di Aihui;Zhang Yan(Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院放射科,北京100191

出　　处：《中华医学杂志》2022年第43期3457-3462,共6页National Medical Journal of China

摘　　要：目的探讨冠状动脉CT血管成像(CCTA)100 kVp碘流率降低至120 kVp水平60%的可行性。方法纳入2022年2至7月于北京大学第三医院放射科因临床怀疑冠心病行CCTA检查的受检者205例,其中男105例,女100例,年龄23~87(60±13)岁。根据受检者体重分成5组,分别为<50 kg、50~59 kg、60~69 kg、70~79 kg、≥80 kg。所有病例均采用100 kVp管电压扫描并联合混合迭代重建技术(KARL 3D)重建,碘流率注射方案设置为120 kVp碘流率标准的60%(在指南基础上降低了10%),各组碘流率分别为0.9、1.0、1.1、1.3及1.4 gI/s。比较5组受检者CCTA的主动脉根部、左前降支近段及右冠状动脉远段管腔的CT值及噪声(SD值),左前降支及右冠状动脉信噪比(SNR)和对比噪声比(CNR),冠状动脉主观评分及有效辐射剂量(ED)差异。采用单因素方差分析或秩和检验分析以上指标的组间统计学差异。结果5组主动脉根部、左前降支近段及右冠状动脉远段管腔CT值及SD值,左前降支近段及右冠状动脉远段管腔SNR和CNR,以及冠状动脉主观评分,差异均无统计学意义(均P>0.05)。5组间CCTA检查对比剂用量和ED差异均有统计学意义(均P<0.05),对比剂用量分别为30、34、38、43及48 ml,ED[M(Q_(1),Q_(3))]分别为2.24(1.88,2.56)、2.62(2.24,3.17)、2.70(2.48,3.20)、4.13(3.85,4.40)及4.44(4.01,5.02)mSv。结论CCTA100 kVp碘流率注射方案降低至120 kVp碘流率的60%具有可行性,值得推广。Objective To investigate the feasibility of reducing the iodine delivery rate(IDR)of coronary CT angiography(CCTA)with 100 kVp to 60%of 120 kVp standard.Methods A total of 205 patients(105 males and 100 females,aged from 23 to 87 years)underwent CCTA due to suspected coronary artery disease in Department of Radiology of Peking University Third Hospital from February to July 2022 were enrolled.Those patients were divided into five subgroups according to their body weight:<50 kg,50 to 59 kg,60 to 69 kg,70 to 79 kg and≥80 kg,respectively.All the cases were scanned with 100 kVp tube voltage and combined with mixed iterative reconstruction technology KARL 3D.The IDR injection protocol was set to 60%of the 120 kVp IDR standard(10%lower than the guideline),and the IDR of each group was 0.9,1.0,1.1,1.3 and 1.4 gI/s,respectively.The CT attenuations(CT value)and noise(SD value)of the aortic root,proximal left anterior descending branch and the distal segments of the right coronary artery,the signal-to-noise ratio(SNR)and contrast noise ratio(CNR)of proximal left anterior descending branch and the distal segments of the right coronary artery,the whole subjective image quality scores of the coronary artery,and effective dose(ED)of CCTA in the five groups were compared.The One-way ANOVA or Kruskal-walls test was used for statistical analysis.Results There was no significant difference in CT attenuations and noise of aortic root,proximal left anterior descending and the distal segments of the right coronary artery,SNR and CNR of proximal left anterior descending branch and the distal segments of the right coronary artery,and subjective image quality scores among the five groups(all P>0.05).The difference of the dosage of contrast medium and ED among the five groups were statistically significant(all P<0.05).The dosage of contrast medium in the five groups were 30,34,38,43 and 48 ml,and the ED in the five groups was 2.24(1.88,2.56),2.62(2.24,3.17),2.70(2.48,3.20),4.13(3.85,4.40)and 4.44(4.01,5.02)mSv,respectively.Conclusion I

关 键 词：放射学 体层摄影术 X线计算机 冠状动脉CT血管成像 体重 碘流率 横断面研究 

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