评估高浓度对比剂联合低管电流在克罗恩病CTE检查的图像质量及辐射剂量  

To Evaluate the Image Quality and Radiation Dose of High Concentration Contrast Agent Combined with Low Tube Current in CTE Examination of Patients with Crohn's Disease

作　　者：王晓红 郭庆强[1] 宋曼[1] WANG Xiao-hong;GUO Qing-qiang;SONG Man(Department of Radiology,The First Affiliated Hospital of Xiamen University,Xiamen 361000,Fujian Province,China)

机构地区：[1]厦门大学附属第一医院放射科,福建厦门361000

出　　处：《中国CT和MRI杂志》2024年第11期144-146,共3页Chinese Journal of CT and MRI

摘　　要：目的这项研究通过比较不同浓度对比剂联合不同管电流在克罗恩病患者的腹部CT血管成像质量及肠壁相对强化值,从而探讨高浓度对比剂联合低管电流扫描方式在克罗恩病患者小肠CT造影的应用价值。方法52例连续患者随机分为低浓度组(A组)和高浓度组(B组),两组患者均行CTE检查,扫描时应用相同的管电压、注射速率、对比剂用量,将动脉期扫描数据作为研究对象,A组(碘浓度为300mg/mL的碘普罗胺)使用自动mAs,B组(碘浓度为400mg/mL的碘美普尔)使用0.6倍自动mAs;比较A组和B组有效辐射剂量及肠系膜上动脉起始段的图像质量客观评价指标(强化程度、信噪比、对比噪声比)、主观评价指标,病灶区域肠壁强化进行以CT值测量为基础的客观评价。结果B组较A组有效剂量降低约40%;B组在动脉期肠系膜上动脉起始段的CT值(366.9±56.5)及相对强化值(321.4±56.4)均高于A组在动脉期肠系膜上动脉起始段的CT值(286.1±36.2)及相对强化值(240.9±36.6),差异有统计学意义(P<0.001);B组在动脉期肠系膜上动脉起始段的CNR(30.4±8.9)及SNR(36.4±10.0)均高于A组在动脉期肠系膜上动脉起始段的CNR(22.0±5.4)及SNR(27.3±6.3),差异有统计学意义(P<0.001);B组在动脉期病变肠壁的CT值(111.7±13.8)及相对强化值(72.5±12.8)均高于A组在动脉期病变肠壁的CT值(94.1±18.2)及相对强化值(48.2±20.7),并且B组在动脉期病变肠壁的相对强化CT值>50HU;A、B两组图像质量主观评分分别为(4.04±0.445)、(4.15±0.464),A、B两组图像质量主观评价无统计学意义(P>0.05)。结论在克罗恩病患者CTE检查中应用高浓度对比剂注射方案联合低管电流,能大幅度降低了患者接受的辐射剂量,对肠系膜上动脉起始段强化程度更高、图像质量更佳,对病变肠壁强化更明显。Objective In this study,the quality of abdominal CT angiography and the relative enhancement value of intestinal wall in patients with Crohn's disease were compared by comparing different concentrations of contrast agent combined with different tube currents,so as to explore the application value of high concentration contrast agent combined with low tube current scanning in small intestine CT angiography of patients with Crohn's disease.Methods 52 consecutive patients were randomly divided into low concentration group(group A)and high concentration group(group B).Both groups of patients underwent CTE examination.The same tube voltage,iodine flow rate and contrast agent dosage were used during scanning.The arterial phase scan data were taken as the research object.Group A(iodine concentration of 300mg/mL iopromide)used automatic mAs,and group B(iodine concentration of 400mg/mL iopromide)used 0.6 times automatic mAs;the objective evaluation indexes of image quality(enhancement degree,signal-to-noise ratio,contrast-to-noise ratio),subjective evaluation indexes and effective radiation dose of superior mesenteric artery in group A and group B were compared,The enhancement of intestinal wall in the lesion area was evaluated objectively based on CT value measurement.Results Compared with group A,the effective dose of group B was reduced by about 40%.And in group B,the relative enhancement CT value of the intestinal wall in the arterial phase was>50HU;the CT value(366.9±56.5)and relative enhancement value(321.4±56.4)of the initial segment of superior mesenteric artery in arterial phase in group B were higher than the CT value(286.1±36.2)and relative enhancement value(240.9±36.6)of those in group A,and the difference was statistically significant(P<0.001).The CNR(30.4±8.9)and SNR(36.4±10.0)of the initial segment of superior mesenteric artery in group B were higher than the CNR(22.0±5.4)and SNR(27.3±6.3)of those in group A,and the difference was statistically significant(P<0.001),The CT value(111.7±13.8)and relat

关 键 词：高浓度对比剂 低管电流 克罗恩病 小肠CT造影 图像质量 辐射剂量 

分 类 号：R656.7[医药卫生—外科学]