低辐射剂量和低对比剂剂量的下肢CTA方案在疑似糖尿病下肢动脉闭塞性病变检查中的应用  

The Application of Lower Limb CTA Protocol with Low Radiation Dose and Low Contrast Agent Dose in the Examination of Lower Limb Arterial Occlusive Lesions of Suspected Diabetes

作　　者：杜森垚 徐江 朱杰 司成海[1] DU Sen-yao;XU Jiang;ZHU Jie;SI Cheng-hai(Department of Imaging,The First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Department of General Medicine,The First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Department of Imaging,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei Province,China)

机构地区：[1]秦皇岛市第一医院影像科,河北秦皇岛066000 [2]秦皇岛市第一医院综合内科,河北秦皇岛066000 [3]秦皇岛市中医医院影像科,河北秦皇岛066000

出　　处：《中国CT和MRI杂志》2023年第11期153-155,共3页Chinese Journal of CT and MRI

基　　金：河北省科学技术成果(低放射线剂量及低对比剂剂量行糖尿病下肢动脉CTA的应用研究)(20170793)。

摘　　要：目的探讨低辐射剂量和低对比剂剂量的下肢动脉血管成像(CTA)在疑似糖尿病下肢动脉闭塞性病变(ASO)检查中的应用价值。方法选取2019年6月至2022年12月在本院进行下肢CTA检查的疑似糖尿病下肢动脉闭塞性病变患者共110例,随机数表法分成常规组(管电压120 kV、对比剂100 mL)和研究组(管电压100 kV,对比剂1 mL/kg)各55例。参照数字减影血管造影(DSA)比较两组诊断效果,同时分析下肢CTA图像质量、碘摄入量和辐射剂量。结果参照DSA金标准,2组CTA对下肢动脉狭窄程度的诊断符合率、ASO诊断效果比较,差异均不显著(P>0.05)。2组下肢CTA主观图像质量评分比较,差异不显著(P>0.05),研究组背景噪声较常规组高(P<0.05),信噪比(SNR)较常规组低(P<0.05)。研究组对比剂剂量、碘摄入量较常规组平均减少了32.65 mL、11.43g,CT剂量指数(CTDIvol)、剂量长度乘积(DLP)和有效辐射剂量(ED)均低于常规组(P<0.05)。结论低辐射剂量和低对比剂剂量的下肢CTA方案在疑似糖尿病ASO检查中是可行的,在图像质量不影响诊断效果的前提下,能明显减少对比剂剂量、碘摄入量和辐射剂量,提高下肢CTA检查的安全性。Objective To explore the application value of lower extremity arterial angiography(CTA)with low radiation dose and low contrast agent dose in the examination of lower extremity arterial occlusive lesions(AS O)in suspected diabetes.Methods From June 2019 to December 2022,110 patients with suspected lower limb arterial occlusive disease of diabetes who underwent lower limb CTA in our hospital were randomly divided into the conventional group(120 kV tube voltage,100 mL contrast medium)and the study group(100 kV tube voltage,1 mL/kg contrast medium)with 55 cases each.Compare the diagnostic effects of two groups with digital subtraction angiography(DSA),and analyze the image quality,iodine intake,and radiation dose of lower limb CTA.Results According to the DSA gold standard,there was no significant difference(P>0.05)between the two groups in the diagnostic accuracy and ASO diagnostic effect of CTA on the degree of lower limb arterial stenosis.The comparison of subjective image quality scores of lower limb CTA between the two groups showed no significant difference(P>0.05).The background noise of the study group was higher than that of the conventional group(P<0.05),and the signal-to-noise ratio(SNR)was lower than that of the conventional group(P<0.05).The study group showed an average reduction of 32.65 mL and 11.43g in contrast agent dose and iodine intake compared to the conventional group.The CT dose index(CTDIvol),dose length product(DLP),and effective radiation dose(ED)were all lower in the study group than in the conventional group(P<0.05).Conclusion The lower limb CTA scheme with low radiation dose and low contrast agent dose is feasible in ASO examination of suspected diabetes.On the premise that the image quality does not affect the diagnostic effect,it can significantly reduce the contrast agent dose,iodine intake and radiation dose,and improve the safety of lower limb CTA examination.

关 键 词：糖尿病 下肢动脉闭塞性病变 动脉血管成像 辐射剂量 对比剂 数字减影血管造影 

分 类 号：R445.6[医药卫生—影像医学与核医学]