320排探测器CT双低剂量胸痛三联征CT血管成像扫描方案对急性胸痛的可行性分析  

Feasibility of low radiation dose and low contrast dosage for triple-rule-out CT angiography of chest pain on the 320-row detector CT

作　　者：周琳夕 叶晓丹 杨舒一 张利军 陈亮 周恒 李静 严诚 ZHOU Linxi;YE Xiaodan;YANG Shuyi;ZHANG Lijun;CHEN Liang;ZHOU Heng;LI Jing;YAN Cheng(Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Lianying Medical Technology Co.,Ltd.,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放射诊断科,上海200032 [2]上海联影医疗科技股份有限公司,上海200032

出　　处：《实用放射学杂志》2024年第9期1532-1535,共4页Journal of Practical Radiology

摘　　要：目的 探讨320排探测器CT双低剂量扫描方案在胸痛三联征CT血管成像(TRO-CTA)的可行性分析.方法 前瞻性选取行CTA的120例受检者,分为对照组(90例)和试验组(30例).对照组行常规剂量的肺动脉CTA(120 kV管电压,45 mL对比剂)、冠状动脉 CTA(120 kV,50~60 mL)、主动脉 CTA(120 kV,75 mL).试验组行 TRO-CTA(100 kV,70~80 mL),试验组通过小剂量检测法测出肺动脉和主动脉处对比剂达到峰值的时间,对照组按序进行造影检查.测量并比较试验组和对照组中的肺动脉、冠状动脉、主动脉的主观评分和客观图像质量.记录并比较2组受检者的有效剂量(ED).采用独立样本t检验和Fisher确切概率法分析以上指标间的组间统计学差异.结果 试验组和对照组肺动脉、冠状动脉和主动脉的CT值、对比噪声比(CNR)、信噪比(SNR)无统计学差异(P>0.05).2组肺动脉、冠状动脉、主动脉段的平均主观评分均≥3分,符合临床诊断要求.2组主观评分无统计学差异(P>0.05).2组ED有统计学差异(P<0.05).试验组冠状动脉、肺动脉、主动脉的ED分别较对照组降低11.49%、13.33%和11.46%.结论 在320排探测器CT上使用双低剂量扫描方案可获得满足诊断要求的TRO-CTA图像.在不影响TRO-CTA的前提下,可合理减少辐射剂量和对比剂用量.Objective To invesigate the feasibility of low radiation dose and low contrast dosage in triple-rule-out computed tomo-graphy angiography(TRO-CTA)on the 320-row detector CT.Methods A total of 120 patients who underwent CTA were prospec-tively selected.All patients were divided into control group(n=9)and experimental group(n=30).The control group employed standard-doses protocol of pulmonary CTA(120 kV tube voltage,45 mL contrast dosage),coronary CTA(120 kV,50-60 mL),and aortic CTA(120 kV,75 mL),while the experimental group received TRO-CTA with 100 kV and 70-80 mL.The peak time of contrast dosage at the pulmonary artery and aorta was measured by low-dose detection method in the experimental group,and the contrast examination was performed sequentially in the control group.Subjective scores and objective image quality of the pulmonary artery,coronary artery,and aorta in the experimental group and the control group were measured and compared,respectively.The effective dose(ED)between the two groups were recorded and compared.Independent samples t-test and Fisher exact probability were used to analyze the statistical differences between the above measures.Results There were no significant differences in CT values,con-trast-to-noise ratio(CNR),signal-to-noise ratio(SNR)of pulmonary artery,coronary artery and aorta between the two groups(P>0.05).The mean subjective scores of pulmonary artery,coronary artery and aorta segments in the two groups were not less than 3 points,meeting the requirement of clinical diagnosis.There was no statistical difference in subjective scores between the two groups(P>0.05).There was statistically significant difference in ED between the two groups(P<0.05).The ED of pulmonary artery,coronary artery,and aorta in the experimental group were 11.49%,13.33%,and 11.46%significantly lower than those in the control group,respec-tively.Conclusion It is feasible to obtain TRO-CTA images used by the low radiation dose and low contrast dosage on the 320-row detector CT,and radiation dose and contrast

关 键 词：计算机体层成像 胸痛三联征CT血管成像 小剂量检测法 肺动脉 冠状动脉 主动脉 

分 类 号：R814.42[医药卫生—影像医学与核医学] R561[医药卫生—放射医学] R814.43[医药卫生—临床医学]