宽体探测器CT冠状动脉血管成像中应用三低扫描成像技术的可行性分析  

Feasibility analysis of wide-detector CT coronary angiography using three-low scanning technology

作　　者：张梓雄 乔文俊[2] 张菁菁 杨蔓蔓 陈佳轶 周美娟[1] ZHANG Zixiong;QIAO Wenjun;ZHANG Jingjing;YANG Manman;CHEN Jiayi;ZHOU Meijuan(School of Public Health,Southern Medical University,Guangzhou 510515,China;Medical Imaging Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学公共卫生学院,广东广州510515 [2]南方医科大学南方医院医学影像中心,广东广州510515

出　　处：《中国医学物理学杂志》2025年第3期374-380,共7页Chinese Journal of Medical Physics

摘　　要：目的:分析不同扫描参数及对比剂注射方案,研究应用低辐射剂量、低注射速率及低对比剂用量的三低扫描成像技术在宽体探测器CT冠状动脉血管成像中的可行性。方法:招募210例行冠状动脉血管成像的患者,并随机分为A组(常规组,n=105)和B组(三低组,n=105),宽体探测器CT采用美国GE公司的Revolution CT。A、B组的管电压分别为120、100 kV;对比剂注射速率和注射用量分别依据身体质量指标及心率的计算。通过测量图像CT值、图像信噪比及对比噪声比来客观评价图像质量;利用Likert 5分法进行主观图像质量评价。结果:两组基本资料信息比较,差异无统计学意义(P>0.05);A和B两组所得冠脉图像主动脉窦口CT值为(442.70±58.26)、(454.11±62.36)HU,两组图像CT值、图像评分、图像信噪比及对比噪声比的差异无统计学意义(P>0.05),对比剂注射速率、对比剂用量、管电流、有效辐射剂量的差异有统计学意义(P<0.05),B组相比A组减少33.89%的有效辐射剂量。结论:基于患者身体质量指标及心率的个性化定制对比剂注射方案,常规组及三低组均能获得满足影像诊断的图像质量,且三低组图像质量更优,即三低方案可在获得更优质图像质量的前提下降低患者受照剂量和减少对比剂的使用,从而使患者获益更多。Objective To analyze various scanning parameters and contrast agent injection schemes,and explore the feasibility of three-low scanning technology characterized by lower radiation dose,slower injection rate and reduced contrast agent dosage in coronary angiography with wide-detector CT.Methods A total of 210 patients who underwent coronary angiography were recruited and randomly divided into group A(routine group,n=105) and group B(three-low group,n=105),and all of them were examined using the Revolution CT from the American GE company.Group A and group B adopted120 and 100 kV tube voltages,respectively.The contrast injection rate and contrast agent dosage were calculated using formulas based on body mass index and beat per minute.Image quality was objectively evaluated using CT number,signal-tonoise ratio and contrast-to-noise ratio,and subjectively scored using Likert 5-point method.Results No statistical differences were found in the basic data between two groups(P>0.05).The CT numbers of the aortic sinus orifice in coronary artery images obtained from group A and group B were(442.70±58.26) and(454.11±62.36) HU,respectively.The differences between two groups in CT number,image score,signal-to-noise ratio,and contrast-to-noise ratio were trivial(P>0.05),while statistically significant differences were noted in injection rate,contrast agent dosage,tube current,and effective radiation dose(P<0.05).Group B reduced the effective radiation dose by 33.89% as compared with group A.Conclusion Based on the patient's body mass index and beat per minute,a personalized contrast agent injection scheme can be developed.Both routine group and three-low group can obtain image quality that meets imaging diagnosis requirements,and the latter has better image quality,demonstrating that the three-low scheme benefits the patients more for it can reduce the patient's radiation dose and contrast agent dosage while achieving higher image quality.

关 键 词：冠状动脉 三低扫描 辐射剂量 注射速率 对比剂用量 

分 类 号：R318[医药卫生—生物医学工程] R816[医药卫生—基础医学]