双低剂量联合迭代重建技术在急性脑梗死容积CT全脑灌注成像中的可行性应用

发布时间：2019-05-12 13:48

【摘要】：目的:探讨低浓度对比剂、低管电压联合迭代重建技术在急性脑梗死患者全脑灌注成像(CTP)中的可行性应用。方法:选取2014年9月-2015年3月在徐州医学院徐州临床学院行全脑CTP检查、临床拟诊为急性脑梗死患者59例,随机分为A、B两组,A组28例[管电压100kV,对比剂为碘海醇(350mg I/mL),滤波反投影重建法(FBP)重建];B组31例[管电压80kV,对比剂为碘克沙醇(270mg I/mL),迭代重建算法(ART)重建]。测量并计算A、B两组的大脑中动脉CT值、信噪比(SNR)、对比噪声比(CNR)、剂量长度乘积(DLP)、有效辐射剂量(ED)及碘摄入量,并对两组间上述指标进行统计学分析;2名医师对两组图像质量评价的一致性采用kappa分析;两组间图像质量主观评价差异采用χ2检验。结果:A、B两组间的CT值、SNR、CNR、CTP及CTA的图像主观质量评价差异均无统计学意义(P均0.05);两组间梗死灶的检出率无统计学差异;而B组(双低剂量组)的ED、碘摄入量较A组低。结论:联合低管电压和迭代重建技术时,使用低浓度对比剂(270mg I/mL)进行全脑CTP检查,在不降低图像质量的同时,还能减少ED及碘摄入量,从而降低对比剂肾病(CIN)的风险。
[Abstract]:Objective: to investigate the feasibility of low concentration contrast agent and low tube voltage combined iterative reconstruction in (CTP) of patients with acute cerebral infarction. Methods: the whole brain CTP was performed in Xuzhou Clinical College of Xuzhou Medical College from September 2014 to March 2015. 59 patients with acute cerebral infarction were randomly divided into two groups: group A (n = 28), group A (n = 28). The contrast agent was iodohexol (350mg I/mL), and (FBP) reconstruction was performed by filter backprojection reconstruction]. Group B (31 cases) [tube voltage 80 kV, contrast agent 270mg I/mL, iterative reconstruction algorithm (ART) reconstruction]. The CT values of middle cerebral artery (MCA) and signal-to-noise ratio (SNR) (SNR), of group A and group B were measured and calculated, and the effective radiation dose (ED) and iodine intake of (DLP), were compared with those of (CNR), dose length, and the above indexes were statistically analyzed between the two groups. The consistency of image quality evaluation between the two groups was analyzed by kappa, and the subjective evaluation difference of image quality between the two groups was tested by 蠂 2 test. Results: there was no significant difference in CT value, subjective quality evaluation of SNR,CNR,CTP and CTA between group B and group B, but there was no significant difference in the detection rate of infarction between the two groups. The intake of ED, iodine in group B (double low dose group) was lower than that in group A. Conclusion: when combined with low tube voltage and iterative reconstruction technique, the whole brain CTP examination with low concentration contrast agent (270mg I/mL) can not only reduce the image quality, but also reduce the intake of ED and iodine. Thus reducing the risk of (CIN) in contrast agent nephropathy.
【作者单位】：徐州医学院徐州临床学院影像科;徐州医学院徐州临床学院神经内科;徐州医学院附属医院影像科;
【基金】：徐州市科技局科技项目(XM13B076)
【分类号】：R743.3;R816.1

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