降低碘剂用量个性化方案在头颈部CTA的应用价值研究  

Study on the Application Value of Individualized Program to Reduce Iodine Dosage in Head and Neck CTA

作　　者：韦家旭 所世腾[1] 任禹笛 赵亦舟 王嘉诚 王嵇[1] WEI Jiaxu;SUO Shiteng;REN Yudi;ZHAO Yizhou;WANG Jiacheng;WANG Ji(Department of Radiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海市200127

出　　处：《中国医学计算机成像杂志》2024年第6期658-663,共6页Chinese Computed Medical Imaging

摘　　要：目的:探讨头颈部CT血管成像(CTA)中使用低碘对比剂用量的可行性。方法:前瞻性收集在我院行头颈CTA检查的90例患者,将其随机分为常规组、对照组、高浓度组,每组30例。常规组管电压、对比剂碘浓度、单位体重对比剂用量分别为110 kV、350 mg/mL、0.8 mL/kg,对照组上述参数分别为90 kV、350 mg/mL、0.6 mL/kg,高浓度组则分别为90 kV、400 mg/mL、0.4 mL/kg。分别测量动脉期横断面图像的主动脉弓,双侧颈总动脉、颈内动脉C1段、颈内动脉海绵窦段、大脑中动脉M1段这5个水平的CT值,并计算信噪比(SNR)和对比度噪声比(CNR),记录3组间患者的碘摄入量、剂量长度乘积(DLP)和有效剂量(ED)。结果:3组血管CT值比较分析,常规组显著低于高浓度组(P<0.01)。3组间CNR、SNR差异均具有统计学意义(P<0.001),两两比较,常规组显著高于对照组和高浓度组(P<0.05)。主观图像质量评价上,3组间差异无统计学意义(P=0.634)。3组患者间的碘剂用量、碘摄入量、长度乘积、有效剂量差异均具有统计学意义(P<0.001)。结论:降低碘剂用量个性化方案在头颈部CTA的应用可以有效降低碘剂用量,且图像质量不输常规扫描。Purpose: To explore the feasibility of using low iodine contrast agent in head and neck computed tomography angiography(CTA).Methods: A total of 90 patients who underwent head and neck CTA examination in our hospital were prospectively collected and randomly divided into a conventional group, a control group, and a high concentration group, with 30 patients in each group. In conventional group, the voltage, iodine concentration of contrast agent, and contrast agent dose per unit weight were 110 k V, 350 mg/m L, and 0.8 m L/kg, respectively. The control group had the above parameters of 90 k V, 350 mg/m L, and 0.6 m L/kg, respectively, while the high concentration group had the parameters of 90 k V, 400 mg/m L, and 0.4 m L/kg, respectively. The CT values of aortic arch, bilateral common carotid arteries, C1 segments of bilateral internal carotid arteries, cavernous sinus segments of bilateral internal carotid arteries, and M1 segments of bilateral middle cerebral arteries were measured on crosssectional images during the arterial phase, and the signal-to-noise ratio(SNR) and contrast-to-noise ratio(CNR) were calculated. The iodine intake, dose-length product(DLP), and effective dose(ED) of patients in the three groups were recorded. Results: The vascular CT values in the conventional group was significantly lower than those in the high concentration group(P<0.01). The differences in CNR and SNR among the three groups were statistically significant(P<0.001), and pairwise comparisons showed that the conventional group was significantly higher than the control group and the high concentration group(P<0.05). There was no statistically significant difference in subjective image quality evaluation among the three groups(P=0.634). The differences in iodine dosage, iodine intake, DLP and ED among the three groups of patients were statistically significant(P<0.001). Conclusion: The application of personalized protocols in head and neck CTA can effectively reduce iodine dosage, and the image quality is not inferior to that

关 键 词：碘剂用量 低剂量 个性化方案 CT血管成像 头颈部 

分 类 号：R445.3[医药卫生—影像医学与核医学]