基于宽体探测器不同扫描方案在超重患者冠状动脉CT血管成像中的可行性研究  

The feasibility study of different scan protocols in coronary CT angiography of overweight patients based on wide-detector

作　　者：刘治超 赵赛 马泽鹏 刘奕文 栗雪然 蔡梦怡 赵永霞[1] LIU Zhichao;ZHAO Sai;MA Zepeng;LIU Yiwen;LI Xueran;CAI Mengyi;ZHAO Yongxia(Department of Radiology,the Affiliated Hospital of Hebei University,Baoding,Hebei Province 071000,China;Hebei University,Baoding,Hebei Province 071000,China;Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]河北大学附属医院放射科,河北保定071000 [2]河北大学,河北保定071000 [3]华中科技大学同济医学院附属协和医院放射科,湖北武汉430022

出　　处：《实用放射学杂志》2024年第7期1160-1164,共5页Journal of Practical Radiology

基　　金：河北省2020年度重点研发计划项目(20377765D);河北省2020年度医学科学研究课题计划项目(20200572);河北省医学适用技术跟踪项目(GZ2023093);河北大学医学学科培育项目(2021A10);保定市科技计划项目(2141ZF307);大学生创新创业项目(202310075014)。

摘　　要：目的探讨基于宽体探测器使用不同管电压及不同浓度对比剂(CM)在超重患者冠状动脉CT血管成像(CCTA)中图像质量、辐射剂量和CM摄入量的比较研究。方法将行CCTA检查体质量指数(BMI)≥25 kg/m2的150例超重患者按扫描方案分为A组(120 kVp,370 mg I/mL CM)、B组(100 kVp,350 mg I/mL CM)和C组(80 kVp,320 mg I/mL CM),每组50例。测量和计算所有患者图像的CT值平均值、信噪比(SNR)平均值、对比噪声比(CNR)平均值、品质因数(FOM);由2位高年资影像诊断医师采用双盲5分值法对所有图像进行评分。记录所有患者的容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP),并计算有效剂量(ED)。计算3组患者的碘摄入量值。采用单因素方差分析比较上述数值。结果B组和C组图像的CT值平均值、SNR平均值、CNR平均值和主观评分平均值均高于A组(P<0.001),但B组和C组图像的上述数值无统计学差异(P>0.05);B组和C组的FOM值高于A组(P<0.001),而B组的FOM值低于C组(P<0.001);B组和C组的碘摄入量值低于A组(P<0.001)。B组和C组的ED和碘摄入量值较A组分别降低30.34%、68.53%和10.22%、16.85%(P<0.001)。结论在保证图像质量前提下,基于宽体探测器低管电压联合低浓度CM,与常规扫描方案相比可明显降低超重患者CCTA检查的辐射剂量和碘摄入量。Objective To investigate the image quality,radiation dose and contrast medium(CM)intake in coronary computed tomography angiography(CCTA)of overweight patients based on wide-detector using different tube voltages and CM of different concentrations.Methods A total of 150 overweight patients[body mass index(BMI)≥25 kg/m2]who underwent CCTA were divided into three groups according to scan protocols:group A(120 kVp,370 mg I/mL CM),group B(100 kVp,350 mg I/mL CM),and group C(80 kVp,320 mg I/mL CM),with each group had 50 patients.The mean CT value,mean signal-to-noise ratio(SNR),mean contrast-to-noise ratio(CNR),figure of merit(FOM)of all images were measured and calculated.Images were assessed using a 5-point scale by two radiologists.The volume CT dose index(CTDIvol)and dose length product(DLP)of each patient were recorded and the effective dose(ED)was calculated.The total iodine intake values of patients in three groups were calculated.The above data were statistically analyzed by one-way ANOVA.Results The mean CT value,mean SNR,mean CNR,and mean subjective score of groups B and C were significantly higher than those of group A(P<0.001),but there was no significant difference between groups B and C(P>0.05).The FOM value of groups B and C was significantly higher than that of group A(P<0.001),and the FOM value of group B was significantly lower than that of group C(P<0.001).The total iodine intake values of groups B and C was significantly lower than that of group A(P<0.001).The ED and total iodine intake values in groups B and C were 30.34%,68.53% and 10.22%,16.85% lower than those in group A,respectively(P<0.001).Conclusion Under the premise of ensuring image quality,the lower tube voltage and lower concentration of CM based on wide-detector allows for significant reduction in radiation dose and total iodine intake in CCTA for overweight patients compared to routine scan protocols.

关 键 词：冠状动脉CT血管成像 管电压 对比剂 图像质量 辐射剂量 

分 类 号：R814.43[医药卫生—影像医学与核医学] R9811[医药卫生—放射医学] R723.14[医药卫生—临床医学]