低管电压联合低剂量高浓度对比剂在头颈部CT血管成像中的应用  

Application of low tube voltage combined with low dose and high concentration contrast media in craniocervical CT angiography

作　　者：王绍刚[1] 崔磊[2] 张涛[1] 张学琴[1] 黄爱娜[1] 陈莹[1] WANG Shaogang;CUI Lei;ZHANG Tao;ZHANG Xueqin;HUANG Aina;CHEN Ying(Department of Imaging,the Affiliated Nantong Third Hospital of Nantong University,Nantong,Jiangsu Province 226000,China;Department of Imaging,the Affiliated Second Hospital of Nantong University,Nantong,Jiangsu Province 226000,China)

机构地区：[1]南通大学附属南通第三医院影像科,江苏南通226000 [2]南通大学第二附属医院影像科,江苏南通226000

出　　处：《实用放射学杂志》2023年第4期651-655,共5页Journal of Practical Radiology

基　　金：南通市卫生健康委员会指令性科研项目(MS2022068)。

摘　　要：目的探讨头颈部CT血管成像(CTA)中低管电压联合高浓度对比剂(400mgI/mL)对碘摄入量、辐射剂量及图像质量的影响。方法选取行头颈部CTA检查的150例患者,将其随机分为3组(每组50例),即对照组(A组,120kV、320mgI/mL),低浓度组(B组,100kV、320mgI/mL),高浓度组(C组,100kV、400mgI/mL)。分别测量CTA轴位图像的主动脉弓(AOAR)、颈总动脉(CCA)、颈内动脉C1段(ICAC1)、颈内动脉海绵窦段(ICAC4)、大脑中动脉M1段(MCA M1)5个水平的CT值,并计算信噪比(SNR)和对比噪声比(CNR),记录各组患者的碘摄入量、剂量长度乘积(DLP)和有效剂量(ED)。采用方差分析或非参数检验Kruskal-Wallis检验比较3组间上述指标的差异。结果除了AOAR的SNR和CNR的差异无统计学意义(P>0.05)外,3组患者间的CCA、ICAC1、ICAC4、MCA M1的SNR、CNR的差异均有统计学意义(P<0.05)。C组的图像质量明显优于A组和B组,且可以满足诊断需求。3组患者碘摄入量、对比剂用量、ED的差异均有统计学意义(P<0.05)。C组的对比剂用量和碘摄入量比A、B组分别降低了33%和16%。C组的辐射剂量比A、B组分别降低了52%和20%。3组间图像质量主观评分的差异无统计学意义(P>0.05)。结论采用低管电压联合低剂量高浓度对比剂可以应用于头颈部CTA,能降低辐射剂量和碘摄入量,且保证图像质量。Objective To evaluate the effect of low tube voltage combined with high concentration contrast media(4oo mg I/mL)on iodine intake,radiation dose and image quality in craniocervical computed tomography angiography(CTA).Methods A total of 150 patients who underwent craniocervical CTA were scheduled to three groups randomly:the control group(group A:120 kV,320 mg I/mL),the low concentration group(group B:100 kV,320 mg I/mL)and the high concentration group(group C:100 kV,400 mg I/mL).The CT values of aortic arch(AOAR),common carotid artery(CCA),internal carotid artery C1(ICA C1),internal carotid artery C4(ICA C4)and middle cerebral artery M1(MCA M1)were measured on CTA axial images respectively.Signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.Iodine intake,dose length product(DLP)and effective dose(ED)were recorded.The statistical computations were performed by the variance analysis or non parameter test Kruskal Wallis test.Results There were significant differences in SNR and CNR of CCA,ICA C1,ICA C4 and MCA M1 among the three group(P<0.05),except that of AOAR(P>0.O5).The image quality of group C was significantly better than that of group A and group B,and it could be satisfied with the diagnosis demands.The results of iodine intake,dose of contrast media and ED of three groups were statistically significant(P<0.05).The dose of contrast media and iodine intake of group C decreased by 33%and 16%by comparing with that of group A and group B,while the radiation dose in group C was reduced by 52%and 20%over that of group A and group B respectively.There was no significant difference in subjective score of image quality among the three groups(P>0.05).Conclusion The use of low tube voltage combined with low dose and high concentration contrast media can be applied to the imaging of craniocervical CTA,reducing radiation dose and iodine intake,and ensuring imagequality.

关 键 词：低管电压 高浓度 对比剂 计算机体层成像 血管造影术 

分 类 号：R981.1[医药卫生—药品] R814.42[医药卫生—药学]