低监测阈值和低碘对比剂对头颈CT血管造影应用价值探讨  

Value analysis of low monitoring threshold and low iodine contrast agent dose in head and neck CT angiography

作　　者：李永强 石浩 魏少峰 LI Yongqiang;SHI Hao;WEI Shaofeng(Imaging Department of Puyang Traditional Chinese Medicine Hospital,Puyang,Henan457000,China;Department of Radiology,Puyang Maternal and Child Health Hospital,Puyang,Henan457000,China)

机构地区：[1]濮阳市中医医院影像科,河南濮阳457000 [2]濮阳市妇幼保健院放射科,河南濮阳457000

出　　处：《社区医学杂志》2023年第21期1119-1123,共5页Journal Of Community Medicine

摘　　要：目的通过降低监测阈值、碘对比剂剂量,探讨其在头颈CT血管造影(CTA)中的价值。方法选取2017-06-01-2019-10-01濮阳市中医医院和濮阳市妇幼保健院行CTA检查的患者103例,根据组间基线资料匹配原则分为对照组(n=51)和观察组(n=52)。对照组为60mL CTA碘对比剂,40mL生理盐水,监测阈值150HU;观察组为CTA碘对比剂和生理盐水均40mL,监测阈值90HU。采用χ^(2)检验和t检验对比2组主观图像质量评分、客观图像质量(感兴趣区CT值、图像信噪比、对比噪声比值)、辐射剂量。结果对照组和观察组主观质量评分差异无统计学意义,χ^(2)=0.683,P=0.495;观察组主动脉弓(371.23±60.23)HU、左颈总动脉(471.21±63.25)HU、右颈总动脉(472.35±62.54)HU、左颈内动脉(512.36±70.23)HU、右颈内动脉(520.36±71.41)HU、基底动脉CT值(376.69±40.23)HU、图像信噪比(29.81±6.44)、对比噪声比值(40.65±8.26)和对照组(382.58±62.36)HU、(477.25±65.21)HU、(478.95±64.25)HU、(513.69±72.63)HU、(523.26±71.96)HU、(387.58±42.26)HU、(30.75±6.19)、(41.99±8.22)对比差异无统计学意义,t值分别为0.939、0.477、0.528、0.094、0.205、1.339、0.755、0.825,P值分别为0.350、0.634、0.599、0.925、0.838、0.184、0.452、0.411。观察组上腔静脉CT值(99.36±15.36)HU较对照组(210.25±60.23)HU低,差异有统计学意义,t=23.957,P<0.001;观察组体型特异性剂量估计值(24.01±0.89)mGy、剂量长度乘积(893.56±50.23)mGy·cm均较对照组(32.63±1.88)mGy、(1152.51±49.35)mGy·cm低,差异有统计学意义,t值分别为29.648和26.391,均P<0.001。结论头颈部CTA检查中适当降低监测阈值和碘对比剂剂量不仅可降低辐射剂量和碘摄入量,同时可减少碘对比剂残留,且不会对图像质量造成影响。Objective To explore the value of reducing monitoring threshold and iodine contrast agent dosage in head and neck CT angiography(CTA).Methods A total of 103patients who underwent CTA examination from 2017-06-01to 2019-10-01in Puyang Hospital of Traditional Chinese Medicine and Puyang Maternal and Child Health Hospital were selected and divided into control group(n=51)and observation group(n=52)according to the principle of matching baseline data between groups.The control group was given 60ml CTA iodine contrast dose,40mL normal saline,and the monitoring threshold was 150HU.In the observation group,the dose of CTA iodine contrast agent and normal saline were both 40mL,and the monitoring threshold was 90HU.Chi-square test and t-test were used to compare the subjective image quality score,objective image quality(CT value of area of interest,image signal-to-noise ratio,contrast noise ratio)and radiation dose of the two groups.Results There was no significant difference in subjective quality scores between the control group and the observation group(χ^(2)=0.683,P=0.495).Observation group aortic arch(AOAR)(371.23±60.23)HU,left common carotid artery(CCA)(471.21±63.25)HU,right CCA(472.35±62.54)HU,left internal carotid artery(ICA)(512.36±70.23)HU,right ICA(520.36±71.41)HU,basilar movement pulse(BA)CT value(376.69±40.23)HU,image signal-to-noise ratio(29.81±6.44),contrast noise ratio(40.65±8.26)and control group(382.58±62.36)HU,(477.25±65.21)HU,(478.95±64.25)HU,(513.69±72.63)HU,(523.26±71.96)HU,(387.58±42.26)HU,(30.75±6.19)and(41.99±8.22)were not statistically significant different(t=0.939,P=0.350;t=0.477,P=0.634;t=0.528,P=0.599;t=0.094,P=0.925;t=0.205,P=0.838;t=1.339,P=0.184;t=0.755,P=0.452;t=0.825,P=0.411).Superior vena cava CT value(99.36±15.36)HU in the observation group was lower than that in the control group(210.25±60.23)HU(t=23.957,P<0.001).The size specific dose estimate(SSDE)of(24.01±0.89)mGy and dose-length product(DLP)of(893.56±50.23)mGy·cm in the observation group were lower than those in

关 键 词：低监测阈值 低碘 头颈CT血管造影 辐射剂量 

分 类 号：R816.1[医药卫生—放射医学]