基于复合权重因子对比剂注射法在冠状动脉CTA中的优化研究  

A study on the feasibility of contrast media injection project based on compound body weight factor foroptimizing image quality of coronary CT angiography

作　　者：徐天才 万维佳 夏黎明[2] XU Tian-cai;WAN Wei-jia;XIA Li-ming(Department of Radiology,Jianli People's Hospital,Hubei 433300,China)

机构地区：[1]监利市人民医院放射科,湖北监利433300 [2]华中科技大学同济医学院附属同济医院放射科,湖北武汉430030

出　　处：《放射学实践》2023年第8期1060-1064,共5页Radiologic Practice

摘　　要：目的:探讨基于复合权重因子(CWF)对比剂注射法对优化冠状动脉CTA图像质量的可行性。方法:前瞻性将2023年1月-6月于我院拟行冠状动脉CTA检查的患者纳入本研究,最终将96例符合研究要求的患者随机分为2组:实验组46例,采用改良对比剂注射方案(根据CWF计算对比剂总量和流速);对照组50例,采用传统对比剂注射方案(基于净体重计算对比剂总量)。采用独立样本t检验和卡方检验比较两组受试者的人口学资料(年龄、性别、身高、体重)、18个冠脉节段的CT值及其合格率(管腔CT值>325 HU为合格)、对比剂注射总量、辐射剂量和图像质量主观评级的差异。结果:两组患者各项人口学指标的差异均无统计学意义(P>0.05)。与对照组比较,实验组的冠脉节段CT值合格率较高(83.78%vs.65.16%),差异有统计学意义(χ^(2)=30.62,P<0.05)。实验组对比剂总量低于对照组(50.13 vs.60.00 mL),差异有统计学意义(P<0.05)。实验组的DLP显著低于对照组[(489.30±49.02)vs.(585.11±81.65)mGy·cm],差异有统计学意义(P<0.05)。实验组的图像质量主观评级高于对照组(4级图像占比67.39%vs.60.00%),差异有统计学意义(P<0.05)。结论:在冠状动脉CTA检查中,相比传统的对比剂注射方案,基于复合权重因子的改良注射方案能显著减少对比剂的用量,降低辐射剂量,同时可提供较高的图像质量。Objective:To optimize image quality by the modified contrast injection protocol(CIP)for coronary CT angiography(CCTA)based on compound weight factor(CWF).Methods:From January to June in 2023,the patients in our hospital who proposed to undergo CCTA examination were prospectively collected in this study.Finally,96 patients met the requirements of our study were randomly divided in the two groups:there were 46 cases in experimental group using modified CIP(the volume of contrast media and injection rate were calculated based on CWF),and 50 cases in control group using conventional CIP(the volume of contrast media was calculated based on the lean body weight).Independent sample t-test and Chi-square test were used to compare the differences of demographic data(age,sex,height,weight),CT values of 18 coronary segments and qualification rate,total injection of contrast agent,radiation dose and subjective score of image quality between the two groups.Results:There were no statistical differences in demographic indexes between the two groups(P>0.05).Total injection volume of experimental group was significantly lower than that of control group(50.13 vs.60.00mL,P<0.05).The qualification rate of coronary segments in experimental group was significantly higher than that in control group(83.78%vs.65.16%;χ^(2)=30.62,P<0.05).The subjective scores in experimental group were significantly higher than those in control group(the proportion of coronary segments with optimal quality:67.39%vs.60.0%;χ^(2)=13.12,P<0.05).Radiation dose in experimental group was lower than that in control group[DLP:(489.30±49.02)vs.(585.11±81.65)mGy·cm].Conclusion:The modified injection protocol based on CWF in CCTA examination can reduce injection volume of contrast media and radiation dose and provide reliable image quality.

关 键 词：冠状动脉 CT血管成像 复合权重因子 对比剂注射方案 图像质量 辐射剂量 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.3[医药卫生—放射医学]