体质指数、窄R-R间期结合前瞻性心电门控和迭代重建技术在CTCA三低成像中的应用

发布时间：2018-03-04 23:32

本文选题：冠状动脉　切入点：体层摄影术　出处：《放射学实践》2017年09期 　论文类型：期刊论文

【摘要】：目的:探讨体质指数(BMI)、窄R-R间期结合前瞻性心电门控和迭代重建技术在CTCA三低(低管电压、低对比剂浓度、低对比剂用量)成像中的应用价值。方法:选取300例临床疑有冠状动脉疾病的患者行CTCA检查,分为常规组和实验组;常规组100例,对比剂浓度和管电压分别为350mg I/mL和120kV(350mg I/mL-120kV),BMI≤30kg/m~2;实验组200例,其中100例BMI23kg/m~2的患者按随机数字法分成320mg I/mL-80kV组(A组)和350mg I/mL-120kV组(B组),另100例BMI为23~30kg/m~2的患者按同样方法分成320mg I/mL-100kV组(C组)和350mg I/mL-120kV组(D组),A、B、C、D每组各50例。常规组采用迭代重建技术及350mg I/mL的碘海醇,实验组中A、C两组采用迭代重建技术及320mg I/mL的碘克沙醇,B、D两组采用非迭代重建技术及350mg I/mL的碘海醇;对每位患者的CTCA图像进行主观评分,测量容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(ED)、图像噪声、冠状动脉CT值、信噪比(SNR)和对比噪声比(CNR),并进行统计学分析。结果:常规组与实验组的CTCA图像质量评分差异无统计学意义(P0.05),而碘对比剂用量及辐射剂量两组差异均有统计学意义(P值均0.05);实验组内A组与B组、C组与D组间图像质量主观评分差异均无统计学意义(P值均0.05),而CTDIvol、DLP、ED差异均有统计学意义(P值均0.05)。A组与B组、C组与D组的噪声及CT值差异均有统计学意义(P值均0.05),A组与B组、C组与D组的平均SNR及平均CNR差异均无统计学意义(P值均0.05)。结论:与常规双源CT冠状动脉成像方案相比,基于体质数、窄R-R间期结合前瞻性心电门控与迭代重建技术的CTCA,不仅可大幅降低辐射剂量,同时可以降低碘对比剂浓度和用量,所获得的冠状动脉图像质量均能满足临床诊断要求。
[Abstract]:Objective: to investigate the effects of BMI, narrow R-R interval combined with prospective ECG gating and iterative reconstruction techniques on three low (low tube voltages, low contrast medium concentrations) in CTCA. Methods: 300 patients with suspected coronary artery disease were selected for CTCA examination and divided into routine group and experimental group, 100 cases in routine group, 100 cases in routine group, 100 cases in routine group, 100 cases in routine group, 100 cases in routine group, 100 cases in routine group, The concentration of contrast agent and the tube voltage were 350 mg / mL and 120 kV / mL respectively. One hundred patients with BMI23kg/m~2 were randomly divided into two groups: group A (320mg I / mL-80kV) and group B (350mg / mL-120kV). The other 100 patients with BMI of 2330kg / m-2 were divided into group C (320mg I / mL-100kV) and group D (350mg ImL-120kV). Generation reconstruction technique and 350 mg I / mL iodohexanol, In the experimental group, the two groups were treated by iterative reconstruction technique and 320 mg I / mL iodoxanol / butene D group with non-iterative reconstruction technique and 350 mg I / mL iodosea alcohol respectively. The CTCA images of each patient were evaluated subjectively. Measurement of volumetric dose index CTDIvoll, dose length product (DLPX), effective radiation dose (EDV), image noise, coronary CT value, SNR) and contrast noise ratio were analyzed statistically. Results: there was no significant difference in CTCA image quality score between the routine group and the experimental group (P 0.05), but there were significant differences in the dosage of iodine contrast agent and radiation dose between the two groups. There was no significant difference in subjective score of image quality between group A and group B (P = 0.05), but there were significant differences in DLPnD between group A and group B (P = 0.05) and the noise and CT value of group C and group D in group A and group B (P = 0.05), respectively, in group A and group B (P = 0.05), and in group A and group B (n = 0.05), there was no significant difference in the subjective score of image quality between group A and group B (P = 0.05). There was no significant difference in average SNR and CNR between group A and group B (P = 0.05). Conclusion: compared with conventional dual-source CT coronary angiography, there was no significant difference in average SNR and CNR between group A and group B. Based on body size, narrow R-R interval combined with prospective ECG gating and iterative reconstruction techniques can not only significantly reduce the radiation dose, but also reduce the concentration and dosage of iodine contrast agent. The quality of coronary artery images obtained can meet the requirements of clinical diagnosis.
【作者单位】：西南医科大学附属中医医院放射科;
【基金】：四川省教育厅科研课题(17ZB0483)
【分类号】：R816.2

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