基于患者身材的影像采集参数优化与冠状动脉造影低剂量化的相关性分析  

Correlation analysis between patient stature-based optimization of image acquisition parameters and low-dose coronary angiography

作　　者：钱海[1] 张玉琴[2] 楼钶楠[1] 胡德兴 QIAN Hai;ZHANG Yu-qin;LOU Ke-nan;HU De-xing(Department of Cardiology,Ningbo Medical Center Lihuili Hospital,Ningbo 315040 China;Imagingdepartment,Ningbo Medical Center Lihuili Hospital Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利医院心内科,浙江宁波315040 [2]宁波市医疗中心李惠利医院影像科,浙江宁波315040

出　　处：《中国介入心脏病学杂志》2024年第4期191-196,共6页Chinese Journal of Interventional Cardiology

基　　金：浙江省医药卫生科技计划项目(2022KY1084);浙江省心内科临床重点专科建设项目(2023-SZZ);宁波市重点研发计划项目(2022Z150)。

摘　　要：目的探讨影像采集参数优化与冠状动脉造影辐射剂量和影像质量的相关性。方法选择2022年1月至2024月1月于宁波市医疗中心李惠利医院择期行经皮冠状动脉造影患者60例,采集患者的基本信息和身材数据,根据身体质量指数(BMI)值分为3个组,各BMI组患者随机分入常规模式组(冠状动脉模式采集影像:Cardiac Left Coronary,15帧/秒)和优化模式组(电生理模式采集影像:Cardiac EP,7.5帧/秒),收集辐射剂量数据,并根据影像质量评分表评估影像质量。两组间比较采用独立样本t检验、Mann-Whitney U检验,多组间比较采用单因素方差分析,相关性采用Pearson相关分析。结果患者BMI值越高,胸围越大,辐射剂量越高,呈正线性相关;各BMI组内,优化模式组的各项辐射剂量数据(各类型剂量面积乘积、空气比释动能及胸部皮肤剂量)均低于常规模式组(均P<0.05,降低比率48.95%~70.59%),两组间的影像质量评分差异无统计学意义(P>0.05),均符合手术要求。结论经皮冠状动脉造影的辐射剂量受患者身材、影像采集参数、曝光时长等诸多因素的综合影响,通过优化影像采集参数可在保证影像质量的同时实现辐射低剂量化,减少患者和术者的辐射危害。Objective To explore the correlation among image acquisition parameter optimization,coronary angiography radiation dose and image quality.Methods 60 patients scheduled for elective percutaneous coronary angiography from January 2022 to January 2024 in our hospital were selected.Basic information and body measurements were collected.Patients were divided into three groups based on BMI,and patients in each BMI group were randomly assigned to the conventional mode group(coronary mode image acquisition:Cardiac Left Coronary,15fps)and the optimized mode group(electrophysiology mode image acquisition:Cardiac EP,7.5fps).Radiation dose data were collected.Image quality was evaluated using an image quality scoring table.Independent sample t-tests,Mann-Whitney U tests,and one-way ANOVA were used for comparisons between groups.Pearson analysis was used for correlations.Results Higher BMI and larger chest circumference were associated with higher radiation doses in a positive linear correlation.Within each BMI group,all radiation dose data(Dose-Area Product,Air Kerma and Chest skin dose)were lower in the optimized mode group than in the conventional mode group(all P<0.05,reduction rate 48.95%–70.59%).The diff erence in image quality scores between two groups was not statistically signifi cant(P>0.05),and all images were of the required quality.Conclusions The radiation dose of percutaneous coronary ang iography is affected by the patient’s body size,image acquisition parameters,exposure time and many other factors.Optimizing the image acquisition parameters can ensure the quality of the image while realizing the low dose of radiation and reducing the radiation hazards to the patient and the operator.

关 键 词：冠状动脉造影 影像采集 低剂量 影像质量 

分 类 号：R541[医药卫生—心血管疾病]