双低剂量方案联合SAFIRE技术在胸痛三联征CTA中的应用  

Application of double low-dose combined SAFIRE technique in triple-rule-out CTA of chest pain

作　　者：柳惠彬 唐劲松[1] 李华灿[1] LIU Huibin;TANG Jinsong;LI Huacan(Department of Imaging,Second People’s Hospital of Fujian Province,Fuzhou 350001,China)

机构地区：[1]福建省第二人民医院影像科,福建福州350001

出　　处：《中国中西医结合影像学杂志》2023年第1期69-73,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：福建省中青年教师教育科研项目(JT180231)。

摘　　要：目的:探讨低管电压、低对比剂浓度方案联合正弦图确定迭代重建(SAFIRE)技术在胸痛三联CTA检查中的应用价值。方法:选取80例以胸痛为主要症状行胸痛三联CTA检查的患者,随机分为A、B、C、D组各20例。A组120 kV,对比剂碘浓度370 mg/mL;B组100 kV,对比剂碘浓度370 mg/mL;C组120 kV,对比剂碘浓度300 mg/mL;D组100 kV,对比剂碘浓度300 mg/mL;比较4组的有效辐射剂量、CT值、噪声[包括噪声值(N)、SNR和CNR]及图像质量评分,并进行统计分析。结果:B、D组的有效辐射剂量比A、C组下降约47.6%[(4.3±0.7)mSv vs.(8.2±0.6)mSv],差异有统计学意义(P<0.001);噪声值(N)方面,D组最高,B组次之,A组最低,各组间差异均有统计学意义(均P<0.001);SNR、CNR及图像质量评分方面,B组最高,C组最低,A组略高于D组,各组间差异均有统计学意义(均P<0.05)。B组CT值最高,C组最低。结论:各组扫描方案图像质量最高的为B组,但考虑辐射危害和碘对比剂的肾毒性危害,最理想的为D组方案,即低管电压、低对比剂浓度方案。该方案联合SAFIRE迭代重建技术在胸痛三联CTA检查中,虽然SNR有所下降,但图像仍能满足诊断需求,且同时降低了辐射危害和碘对比剂的肾毒性危害,值得临床推广应用。Objective:To explore the application value of low tube voltage and low contrast concentration combined with sinogram-affirmed iterative reconstruction(SAFIRE)technique in the triple-rule-out CTA of chest pain.Methods:80 patients with triple-rule-out CTA of chest pain were randomly divided into groups A,B,C and D with 20 patients each.The patients in group A underwent CTA with tube voltage of 120 kV and contrast concentration of 370 mg/mL,group B with 100 kV and 370 mg/mL,group C with 120 kV and 300 mg/mL,group D with 100 kV and 300 mg/mL.The effective radiation dose,CT value,noise(including noise value,SNR,CNR)and image quality scores were compared.Results:The effective radiation dose in groups B and D decreased by about 47.6%,compared with that in groups A and C[(4.3±0.7)mSv vs.(8.2±0.6)mSv],there was a significant difference(P<0.001).In terms of the noise value,group D was the highest,followed by group B,and group A was the lowest,with significant difference between groups(P<0.001).In terms of SNR,CNR and image quality score,group B was the highest,group C was the lowest,group A was slightly higher than group D,and the differences between groups were statistically significant(all P<0.05).The CT value of group B was highest,and that of group C was the lowest.Conclusions:In this experiment,the highest image quality of the scanning protocol was group B,considering the radiation hazard and the nephrotoxic hazard of the contrast agent,the optimal plan was group D,low tube voltage and low contrast concentration.The examination with low tube voltage and low contrast concentration combined SAFIRE technology in triple-rule-out CTA for chest pain,although with SNR decreased,but still can meet the diagnostic needs,and reduce the risk of radiation hazard and nephrotoxicity of contrast agent,it is worthy of clinical application.

关 键 词：管电压 对比剂 正弦图确定迭代重建 胸痛三联CTA 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]