基于全体质量、去脂体质量和体表面积的对比剂注射方案在大体质量患者冠状动脉CT血管成像检查中的对比研究  

Comparative study of contrast medium injection schemes based on total body weight,lean body weight,and body surface area in coronary CT angiography of overweight patients

作　　者：赵佳妮 吕婧[1] 张月英[2] 赵蕾[1] 郝欣雨 ZHAO Jiani;LüJing;ZHANG Yueying;ZHAO Lei;HAO Xinyu(Shanxi Medical University,Taiyuan 030000,China;Department of Radiology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学,山西太原030000 [2]山西医科大学第二医院影像科,山西太原030001

出　　处：《实用放射学杂志》2024年第6期981-985,共5页Journal of Practical Radiology

基　　金：山西省重点研发计划基金项目(201903D321192)。

摘　　要：目的探讨大体质量患者冠状动脉CT血管成像(CCTA)中,依据全体质量(TBW)、去脂体质量(LBW)和体表面积(BSA)调整对比剂用量的应用价值。方法前瞻性选取体质量指数(BMI)≥24 kg/m^(2)的150例行CCTA检查的患者,随机分为TBW组、LBW组和BSA组,每组50例。3组均使用对比剂碘克沙醇(320 mg I/mL),固定注射时间12 s。对比剂用量为0.8 mL/kg(TBW);1.04 mL/kg(LBW_(男))、1.11 mL/kg(LBW_(女));BSA 30 mL/m^(2)。比较3组对比剂用量和流速,通过主观、客观方法评估图像质量并分析动脉强化程度与TBW、LBW和BSA的相关性。结果按照5分制评分法,3组图像质量均满足临床诊断需求(均≥3分)。与TBW组相比,LBW组和BSA组的对比剂用量分别降低了13.38%和10.62%,流速分别降低了13.41%和10.61%,差异有统计学意义(P<0.05)。LBW组和BSA组的冠状动脉CT值、信噪比(SNR)和对比噪声比(CNR)均低于TBW组(P<0.05),LBW组CT值的变异范围最小;3组图像质量主观评分差异无统计学意义(P>0.05)。冠状动脉CT值与患者TBW呈弱相关性(r=0.342,P=0.015),与LBW或BSA无相关性(r=-0.207,P=0.150;r=-0.204,P=0.156)。结论LBW是计算大体质量患者冠状动脉增强对比剂用量的最佳身体指数。Objective To explore the application value of adjusting contrast medium dosage according to total body weight(TBW),lean body weight(LBW)and body surface area(BSA)in coronary computed tomography angiography(CCTA)of overweight patients.Methods A total of 150 patients with body mass index(BMI)≥24 kg/m^(2)undergoing CCTA examination were prospectively selected and randomly divided into TBW group,LBW group,and BSA group,with 50 patients in each group.All three groups used contrast medium iodixanol(320 mg I/mL)and the fixed injection time was 12 s.The dosage of contrast medium was 0.8 mL/kg(TBW);1.04 mL/kg(LBW)for male and 1.11 mL/kg(LBW)for female;BSA 30 mL/m^(2).The dosage and flow rate of contrast medium were compared among the three groups,the image quality was evaluated by subjective and objective ways,and the correlation between arterial enhancement and TBW,LBW and BSA were analyzed.Results According to a 5-point scale,the image quality of three groups met the clinical diagnostic requirements(both≥3 points).Compared with TBW group,the dosage of contrast medium in LBW group and BSA group decreased by 13.38%and 10.62%respectively,and the flow rate decreased by 13.41%and 10.61%respectively,and the differences were statistically significant(P<0.05).The coronary CT values,signal-to-noise ratio(SNR)and contrastto-noise ratio(CNR)in LBW and BSA groups were lower than those in TBW group(P<0.05),and the variation range of CT values in LBW group were the smallest.There were no statistical differences in subjective scores of image quality among the three groups(P>0.05).The coronary CT values were slightly correlated with TBW(r=0.342,P=0.015),and were not correlated with LBW or BSA(r=-0.207,P=0.150;r=-0.204,P=0.156).Conclusion LBW is the best body index to calculate the dosage of contrast medium for coronary artery enhancement in overweight patients.

关 键 词：冠状动脉CT血管成像 对比剂 全体质量 去脂体质量 体表面积 

分 类 号：R814.43[医药卫生—影像医学与核医学] R589.2[医药卫生—放射医学] R981.1[医药卫生—临床医学]