基于体表面积的碘对比剂个性化方案在冠状动脉CT血管造影增强效能中的应用  

The application of body surface area-based individualized iodine contrast agent injection protocol in coronary computed tomography angiography enhancing performance

作　　者：赵延洁 王秋霞 张进华 ZHAO Yanjie;WANG Qiuxia;ZHANG Jinhua(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]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：《暨南大学学报（自然科学与医学版）》2024年第3期283-290,共8页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：湖北省自然科学基金项目(2021CFB076)。

摘　　要：目的:探讨体表面积(BSA)的碘对比剂个性化方案在受检者自由呼吸状态下冠状动脉CT血管造影(CTA)效能增强的可行性。方法:将临床疑似冠状动脉疾病的30例患者纳入研究,按BSA分为两组:BSA≤1.6 m^(2)的患者为小BSA组,BSA>1.6 m^(2)的患者为大BSA组。然后基于BSA计算碘对比剂的用量[造影剂用量(mL)=(BSA×10/碘浓度)],造影剂注射时间为10 s。利用Revolution CT在患者自由呼吸状态下对冠状动脉进行造影成像。由具备5年以上胸部影像诊断经验的医师对数据进行主观和客观图像质量评分,采用5分法对A组和B组图像进行主观评分;同时测量两组患者降主动脉、升主动脉、左冠状动脉主干、左前降支、左回旋支、右冠状动脉主干6支血管的CT值及信噪比(SNR)值。结果:两组图像的主观评分数值均能达到3分以上,可满足诊断要求,且两位医师主观评分的一致性(ICC)较好(分别为0.81、0.71)。客观评分结果显示两组图像冠状动脉的显影效果较好,且冠状动脉CT值和SNR值差异无统计学意义(P>0.05)。结论:基于BSA的碘对比剂个性化方案具有临床可行性,冠状动脉血管的强化程度合适且均一,可满足临床诊断要求。Objective:To explore the body surface area(BSA)-based individualized iodine contrast agent protocol in coronary computed tomography angiography(CTA).Methods:Thirty patients suspected of having coronary artery disease were randomly allocated into two groups based on body surface area(BSA):Large BSA group comprised individuals with BSA below 1.6 m^(2),while small BSA group B included those with BSA equal to or above 1.6 m^(2).The dosage of iodine contrast agents was calculated based on BSA×10/iodine concentration,the injection time of the contrast agent is 10 s.Coronary arteries were imaged in the patient's free breathing state using Revolution CT.Radiologists with over 5 years chest imaging diagnosis experience scored the subjective and objective image quality.CT images were subjectively evaluated by the five-point scale,and objectively measured by the CT values and SNR values of the six main blood vessels,including descending aorta,ascending aorta,left coronary artery,left anterior descending artery,left circumflex branch and right coronary artery.Results:The subjective assessment revealed that both groups of images obtained scores exceeding 3 points,meeting diagnostic criteria.Moreover,there was good agreement between the intraclass correlation coefficient(ICC)values of the two physicians(0.81 and 0.71,respectively).Objective evaluation demonstrated satisfactory visualization of coronary arteries in both image sets.Additionally,there were no statistically significant differences in coronary artery CT values and SNR measurements between the two groups(P>0.05).Conclusion:BSA-based individualized contrast agent injection protocol showed clinical feasibility,and the degree of enhancement of the coronary arteries is appropriate and uniform,meeting clinical diagnostic requirements.

关 键 词：体表面积 冠状动脉 CT血管造影 碘对比剂 Revolution CT 

分 类 号：R445.3[医药卫生—影像医学与核医学]