雙源CT低劑量技術(shù)在冠狀動(dòng)脈成像中的臨床應(yīng)用
發(fā)布時(shí)間：2018-09-16 21:27
【摘要】：第一部分雙源CT低管電壓技術(shù)在冠狀動(dòng)脈成像中的臨床應(yīng)用 目的 (1)探討雙源CT (Dual-source CT, DSCT)100、80kV管電壓冠狀動(dòng)脈CTA檢查的可行性及價(jià)值。 (2)評(píng)價(jià)DSCT智能最佳kV掃描技術(shù)(CARE kV)在冠狀動(dòng)脈CTA檢查中的應(yīng)用及價(jià)值。 (3)與傳統(tǒng)濾波反投影(FBP)重建比較,評(píng)價(jià)管電壓100kV下DSCT基于原始數(shù)據(jù)的迭代重建(Sinogram Affirmed Iterative Reconstruction, SAFIRE)在超重患者冠狀動(dòng)脈成像的應(yīng)用價(jià)值。 材料和方法 (1)90例行DSCT冠狀動(dòng)脈成像患者,體重指數(shù)(Body Mass Index,BMI)處于正常范圍內(nèi)(男性：20kg/m2≤BMI25kg/m2,女性：19kg/m2≤BMI24kg/m2),隨機(jī)分成(120kV.362mAs)、(100kV、362mAs)及(80kV、362mAs)三組,每組30例。對(duì)三組的圖像質(zhì)量、平均CT值、圖像噪聲、信號(hào)噪聲比(Signal-to-noise ratio, SNR)、對(duì)比噪聲比(Contrast-to-noise ratio, CNR)及輻射劑量進(jìn)行對(duì)比分析。 (2)150例行DSCT冠狀動(dòng)脈成像患者,體重指數(shù)處于正常范圍內(nèi),隨機(jī)分成5組。A組：管電壓120kV, CARE kV設(shè)置為"Semi"及開(kāi)啟全自動(dòng)動(dòng)態(tài)實(shí)時(shí)射線劑量調(diào)控技術(shù)(CARE Dose4D)(參考電壓120kV、參考電流400mAs); B組：管電壓100kV, CARE kV設(shè)置為"Semi"及開(kāi)啟全自動(dòng)動(dòng)態(tài)實(shí)時(shí)射線劑量調(diào)控技術(shù)(CARE Dose4D)(參考電壓120kV、參考電流400mAs);C組：管電壓80kV,CARE kV設(shè)置為"Semi"及開(kāi)啟全自動(dòng)動(dòng)態(tài)實(shí)時(shí)射線劑量調(diào)控技術(shù)(CAREDose4D)(參考電壓120kV、參考電流400mAs); D組：同時(shí)開(kāi)啟CARE kV及CARE Dose4D(參考電壓120kV、參考電流400mAs), E組：同時(shí)開(kāi)啟CARE kV及CARE Dose4D(參考電壓100kV、參考電流400mAs),每組30例。對(duì)五組的圖像質(zhì)量、平均CT值、圖像噪聲、SNR、CNR及輻射劑量進(jìn)行對(duì)比分析。 (3)將80例體重指數(shù)處于超重患者(男性：25kg/m2≤BMI30kg/m2,女性：24kg/m2≤BMI29kg/m2)行雙源CT冠狀動(dòng)脈成像患者按掃描,管電壓隨機(jī)分成A組(120kV)、B組(100kV),采用FBP法重建,對(duì)B組采用SAFIRE重建得到C組圖像。對(duì)三組的圖像質(zhì)量、平均CT值、圖像噪聲、SNR、CNR及輻射劑量進(jìn)行對(duì)比分析。 結(jié)果 (1)三組圖像質(zhì)量評(píng)分分別為(3.50±0.61)分、(3.43±0.53)分和(3.29±0.82)分,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；120kV組與100kV組的冠狀動(dòng)脈平均CT值及圖像噪聲均低于80kV組,且兩兩比較差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),120kV組與100kV組的冠狀動(dòng)脈的SNR及CNR略高于80kV組,但兩兩比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組患者有效輻射劑量分別為(10.39±1.35)mSv、(7.29±1.36)mSv及(2.80±1.53)mSv,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 (2)五組圖像質(zhì)量評(píng)分分別為(3.42±0.63)分、(3.41±0.54)分、(3.49±0.33)分、(3.45±0.43)分和(3.48±0.81)分,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；C組冠狀動(dòng)脈平均CT值及圖像噪聲均最高,且兩兩比較差異均具有統(tǒng)計(jì)學(xué)意義(P0.05),五組冠狀動(dòng)脈的SNR及CNR之間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。C組輻射劑量最低,且兩兩比較差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。 (3)三組圖像質(zhì)量分別為(3.51±0.70)分、(3.49±0.33)分和(3.55±0.47)分,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；三組平均CT值、圖像噪聲、SNR及CNR比較差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);A組與B組(或C組)兩組間平均CT值比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),且A組平均CT值最低。B組與A組(或C組)兩組間圖像噪聲、SNR及CNR比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),且A組較高。A、C兩組間圖像噪聲、SNR及CNR比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);A、B組(或C組)輻射劑量比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),且B組(或C組)較A組輻射劑量下降約34%。 結(jié)論 (1)對(duì)于體重指數(shù)在正常范圍內(nèi)的患者,采用80kV或100kV管電壓行冠狀動(dòng)脈CTA檢查,可在保證圖像質(zhì)量的同時(shí)顯著降低輻射劑量。 (2)對(duì)于體重指數(shù)在正常范圍內(nèi)的患者,采用同時(shí)開(kāi)啟CARE kV及CARE Dose4D(參考電壓100kV、參考電流400mAs)行冠狀動(dòng)脈CTA檢查,可獲得優(yōu)質(zhì)圖像,并顯著降低輻射劑量。 (3)對(duì)于超重患者,采用100kV管電壓結(jié)合基于原始數(shù)據(jù)的重建(SAFIRE)行冠狀動(dòng)脈CTA檢查,可改善圖像質(zhì)量,顯著降低輻射劑量。 第二部分雙源CT低對(duì)比劑注射方案在冠狀動(dòng)脈成像中的臨床應(yīng)用 目的 (1)通過(guò)DSCT100kV管電壓下三種不同濃度對(duì)比劑在冠狀動(dòng)脈CTA檢查中的應(yīng)用,探討270mgI/ml含碘對(duì)比劑結(jié)合100kV管電壓掃描在冠狀動(dòng)脈CTA檢查中的應(yīng)用價(jià)值。 (2)評(píng)價(jià)DSCT不同管電壓下三種對(duì)比劑注射方案在冠狀動(dòng)脈CTA檢查的圖像質(zhì)量,探討低用量及速率對(duì)比劑注射方案結(jié)合不同低管電壓掃描在冠狀動(dòng)脈CTA檢查中的可行性。 材料和方法 (1)120例行DSCT冠狀動(dòng)脈造影患者隨機(jī)分為3組,體重指數(shù)處于正常范圍內(nèi),分別采用370mgI/ml、320mgI/ml、270mgI/ml濃度的對(duì)比劑,以相同的注射流率(5ml/s)行增強(qiáng)掃描,對(duì)三組冠狀動(dòng)脈分支的顯示率、各個(gè)感興趣區(qū)域平均CT值、圖像噪聲、SNR及CNR進(jìn)行對(duì)比分析。 (2)120例行DSCT冠狀動(dòng)脈造影患者隨機(jī)分為3組,體重指數(shù)處于正常范圍內(nèi),分別采用不同kV匹配三種對(duì)比劑注射方案行增強(qiáng)掃描。A組管電壓120kV,注射對(duì)比劑70ml、生理鹽水30ml,注射速率5.0ml/s;B組管電壓100kV,注射對(duì)比劑60ml、生理鹽水30ml,注射速率4.5ml/s；C組管電壓80kV,注射對(duì)比劑55ml、生理鹽水25ml,注射速率4.0ml/s。評(píng)價(jià)三組上腔靜脈及右心室偽影,并對(duì)三組冠狀動(dòng)脈分支的顯示率、各個(gè)感興趣區(qū)域平均CT值、圖像噪聲、SNR及CNR進(jìn)行對(duì)比分析。 結(jié)果 (1)三組冠狀動(dòng)脈4個(gè)主要分支的顯示率均為100%,其余細(xì)小分支顯示率之間的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組冠狀動(dòng)脈在AAO、DAO、LM、RCA、 LAD、LM及LCX的平均CT值比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05),370組平均CT值最高,270組平均CT值最低。三組冠脈左心室壁(LVW)平均CT值、圖像噪聲、SNR及CNR之間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組間輻射劑量之間差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 (2)A組上腔靜脈及右心室偽影出現(xiàn)比例明顯高于B、C組,且差異均有統(tǒng)計(jì)學(xué)意義(P0.05)：兩兩比較上腔靜脈及右心室偽影在B組與C組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組冠狀動(dòng)脈3個(gè)主要分支的顯示率均為100%,其余細(xì)小分支顯示率之間的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組冠脈圖像噪聲比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),C組圖像噪聲最高。三組冠脈SNR及CNR之間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組冠狀動(dòng)脈在AAO、DAO、LM、RCA、 LAD、LM及LCX的平均CT值比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),C組平均CT值最高,A組平均CT值最低。三組冠狀動(dòng)脈在LVW比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。三組間輻射劑量之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論 (1)對(duì)于體重指數(shù)在正常范圍內(nèi)的患者,100kV管電壓結(jié)合270mgI/ml含碘對(duì)比劑行冠狀動(dòng)脈CTA檢查,在保證圖像質(zhì)量的同時(shí)能達(dá)到“雙低劑量”的效果。 (2)對(duì)于體重指數(shù)在正常范圍內(nèi)的患者,采用不同管電壓(80kV、100kV及120kV)掃描結(jié)合不同的比劑注射方案行冠狀動(dòng)脈CTA檢查,既可保證圖像質(zhì)量又降低對(duì)比劑對(duì)患者的危害,起到了“雙低劑量”的效果。
[Abstract]:Part I clinical application of dual source CT low tube voltage technology in coronary artery imaging
objective
(1) to explore the feasibility and value of dual source CT (Dual-source CT, DSCT) 100,80kV tube voltage coronary CTA examination.
(2) to evaluate the application and value of DSCT intelligent kV scanning technology (CARE kV) in coronary artery CTA examination.
(3) Compared with the traditional filter back projection (FBP) reconstruction, the application value of DSCT based on original data iterative reconstruction (SAFIRE) in coronary artery imaging of overweight patients under 100 kV tube voltage was evaluated.
Materials and methods
(1) 90 patients underwent DSCT coronary angiography were randomly divided into three groups (120 kV.362 mAs, (100 kV, 362 mAs) and (80 kV, 362 mAs) with body mass index (BMI) within the normal range (male: 20 kg/m2 < 25 kg/m2 BMI, female: 19 kg/m2 < 24 kg/m2 BMI), 30 patients in each group. For the three groups, the image quality, average CT value, image noise, signal-to-noise ratio (S/N) Ignal-to-noise ratio (SNR), Contrast-to-noise ratio (CNR) and radiation dose were compared and analyzed.
(2) 150 patients undergoing DSCT coronary angiography were randomly divided into 5 groups with normal body mass index (BMI). Group A: tube voltage 120 kV, CARE kV set to "Semi" and CARE Dose 4D (reference voltage 120 kV, reference current 400 mAs); Group B: tube voltage 100 kV, CARE kV set to "Semi" and open. Automatic dynamic real-time radiation dose control technology (CARE Dose 4D) (reference voltage 120 kV, reference current 400 mAs); group C: tube voltage 80 kV, CARE kV set to "Semi" and turn on automatic dynamic real-time radiation dose control technology (CAREDose 4D) (reference voltage 120 kV, reference current 400 mAs); group D: simultaneously turn on CARE kV and CARE Dose 4D (reference voltage). Group E: Care kV and CARE Dose 4D (reference voltage 100 kV, reference current 400 mAs) were turned on simultaneously, 30 cases in each group.
(3) Eighty patients with body mass index in overweight (male: 25kg/m2 < BMI 30kg/m2, female: 24kg/m2 < BMI 29kg/m2) underwent dual-source CT coronary angiography. The patients were randomly divided into group A (120kV) and group B (100kV). The images of group C were reconstructed by FBP and SAFIRE. Sound, SNR, CNR and radiation dose were compared and analyzed.
Result
(1) The image quality scores of the three groups were (3.50+0.61), (3.43+0.53) and (3.29+0.82) respectively, with no significant difference (P 0.05); the average CT value and image noise of the coronary arteries of the 120 kV group and the 100 kV group were lower than those of the 80 kV group, and the difference was statistically significant (P 0.05). The SNR and CNR of the coronary arteries of the 120 kV group and the 100 kV group were slightly lower than those of the 80 kV group. There was no significant difference between the two groups (P 0.05). The effective radiation doses of the three groups were (10.39 + 1.35) mSv, (7.29 + 1.36) mSv and (2.80 + 1.53) mSv respectively, and the difference was statistically significant (P 0.05).
(2) The image quality scores of the five groups were (3.42+0.63), (3.41+0.54), (3.49+0.33), (3.45+0.43) and (3.48+0.81) respectively, with no significant difference (P 0.05). The average CT value and image noise of coronary artery in group C were the highest, and there was significant difference between the two groups (P 0.05). The SNR and CNR of coronary artery in the five groups were compared. There was no significant difference (P 0.05). The radiation dose of group C was the lowest, and the difference was statistically significant (P 0.05).
(3) The image quality of the three groups were (3.51+0.70), (3.49+0.33) and (3.55+0.47) respectively, with no significant difference (P 0.05); the average CT value, image noise, SNR and CNR of the three groups were statistically significant (P 0.05); the average CT value of group A and group B (or group C) were significantly different (P 0.05), and the average CT value of group A was the highest (P 0.05). The difference of image noise, SNR and CNR between group A and group B (or group C) was statistically significant (P 0.05), and the difference of image noise, SNR and CNR between group A and group C was not statistically significant (P 0.05); the difference of radiation dose between group A and group B (or group C) was statistically significant (P 0.05), and the radiation dose of group B (or group C) was about 34% lower than that of group A.
conclusion
(1) For patients with BMI in the normal range, coronary CTA with 80 kV or 100 kV tube voltage can significantly reduce radiation dose while ensuring image quality.
(2) For patients with BMI in the normal range, coronary CTA can be performed by simultaneously opening CARE kV and CARE Dose 4D (reference voltage 100 kV, reference current 400 mAs) to obtain high quality images and significantly reduce radiation dose.
(3) For overweight patients, 100 kV tube voltage combined with original data-based reconstruction (SAFIRE) for coronary CTA can improve image quality and significantly reduce radiation dose.
The second part is the clinical application of dual source CT low contrast injection in coronary artery imaging.
objective
(1) To investigate the value of 270 mg I/ml iodine-containing contrast medium combined with 100 kV tube voltage scanning in coronary CTA by using three different concentrations of contrast medium under DSCT 100 kV tube voltage.
(2) To evaluate the image quality of three contrast agent injection schemes under different tube voltages in coronary CTA, and to explore the feasibility of low dose and rate contrast agent injection schemes combined with different tube voltages in coronary CTA.
Materials and methods
(1) 120 patients undergoing DSCT coronary angiography were randomly divided into three groups. BMI was within normal range. Contrast agents of 370 mg I/ml, 320 mg I/ml and 270 mg I/ml were used to contrast the coronary artery with the same injection rate (5 ml/s). The display rate of coronary artery branches, the average CT value of each region of interest, image noise, SNR and CNR were performed. Comparative analysis.
(2) 120 patients who underwent DSCT coronary angiography were randomly divided into 3 groups. BMI was within normal range. Three different contrast medium injection schemes were used to enhance the scan. In group A, the tube voltage was 120 kV, the contrast medium was 70 ml, the saline was 30 ml, the injection rate was 5.0 ml/s; in group B, the tube voltage was 100 kV, the contrast medium was 60 ml, and the saline was 30 ml. The artifacts of superior vena cava (SVC) and right ventricle (RV) were evaluated in three groups, and the display rate of coronary artery branches, mean CT value of each region of interest, image noise, SNR and CNR were compared and analyzed.
Result
(1) The displaying rate of four main branches of coronary artery in three groups was 100%. There was no significant difference in the displaying rate of other small branches (P 0.05). The mean CT values of AAO, DAO, LM, RCA, LAD, LM and LCX in three groups were significantly different (P 0.05). The mean CT values of 370 groups were the highest, and the mean CT values of 270 groups were the lowest. There was no significant difference in mean CT value, image noise, SNR and CNR of ventricular wall (LVW). There was no significant difference in radiation dose among the three groups (P 0.05).
(2) The ratio of superior vena cava and right ventricular artifacts in group A was significantly higher than that in group B and group C, and the difference was statistically significant (P 0.05). There was no significant difference between the two groups in the ratio of superior vena cava and right ventricular artifacts between group B and group C (P 0.05). There was no significant difference among the three groups (P 0.05). The difference of coronary image noise among the three groups was statistically significant (P 0.05). The highest noise was found in group C. There was no significant difference between the three groups in coronary SNR and CNR (P 0.05). There was no significant difference in LVW among the three groups (P 0.05). There was significant difference in radiation dose among the three groups (P 0.05).
conclusion
(1) For patients with BMI in the normal range, 100 kV catheter voltage combined with 270 mg I/ml iodine-containing contrast medium for coronary CTA can ensure the image quality and achieve "double low dose" effect.
(2) For patients with BMI in the normal range, different tube voltages (80kV, 100kV and 120kV) scanning combined with different dosage regimens for coronary CTA examination can not only ensure the image quality but also reduce the harm of contrast medium to the patients, thus playing a "double low dose" effect.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R816.2
本文編號(hào)：2244853
[Abstract]:Part I clinical application of dual source CT low tube voltage technology in coronary artery imaging
objective
(1) to explore the feasibility and value of dual source CT (Dual-source CT, DSCT) 100,80kV tube voltage coronary CTA examination.
(2) to evaluate the application and value of DSCT intelligent kV scanning technology (CARE kV) in coronary artery CTA examination.
(3) Compared with the traditional filter back projection (FBP) reconstruction, the application value of DSCT based on original data iterative reconstruction (SAFIRE) in coronary artery imaging of overweight patients under 100 kV tube voltage was evaluated.
Materials and methods
(1) 90 patients underwent DSCT coronary angiography were randomly divided into three groups (120 kV.362 mAs, (100 kV, 362 mAs) and (80 kV, 362 mAs) with body mass index (BMI) within the normal range (male: 20 kg/m2 < 25 kg/m2 BMI, female: 19 kg/m2 < 24 kg/m2 BMI), 30 patients in each group. For the three groups, the image quality, average CT value, image noise, signal-to-noise ratio (S/N) Ignal-to-noise ratio (SNR), Contrast-to-noise ratio (CNR) and radiation dose were compared and analyzed.
(2) 150 patients undergoing DSCT coronary angiography were randomly divided into 5 groups with normal body mass index (BMI). Group A: tube voltage 120 kV, CARE kV set to "Semi" and CARE Dose 4D (reference voltage 120 kV, reference current 400 mAs); Group B: tube voltage 100 kV, CARE kV set to "Semi" and open. Automatic dynamic real-time radiation dose control technology (CARE Dose 4D) (reference voltage 120 kV, reference current 400 mAs); group C: tube voltage 80 kV, CARE kV set to "Semi" and turn on automatic dynamic real-time radiation dose control technology (CAREDose 4D) (reference voltage 120 kV, reference current 400 mAs); group D: simultaneously turn on CARE kV and CARE Dose 4D (reference voltage). Group E: Care kV and CARE Dose 4D (reference voltage 100 kV, reference current 400 mAs) were turned on simultaneously, 30 cases in each group.
(3) Eighty patients with body mass index in overweight (male: 25kg/m2 < BMI 30kg/m2, female: 24kg/m2 < BMI 29kg/m2) underwent dual-source CT coronary angiography. The patients were randomly divided into group A (120kV) and group B (100kV). The images of group C were reconstructed by FBP and SAFIRE. Sound, SNR, CNR and radiation dose were compared and analyzed.
Result
(1) The image quality scores of the three groups were (3.50+0.61), (3.43+0.53) and (3.29+0.82) respectively, with no significant difference (P 0.05); the average CT value and image noise of the coronary arteries of the 120 kV group and the 100 kV group were lower than those of the 80 kV group, and the difference was statistically significant (P 0.05). The SNR and CNR of the coronary arteries of the 120 kV group and the 100 kV group were slightly lower than those of the 80 kV group. There was no significant difference between the two groups (P 0.05). The effective radiation doses of the three groups were (10.39 + 1.35) mSv, (7.29 + 1.36) mSv and (2.80 + 1.53) mSv respectively, and the difference was statistically significant (P 0.05).
(2) The image quality scores of the five groups were (3.42+0.63), (3.41+0.54), (3.49+0.33), (3.45+0.43) and (3.48+0.81) respectively, with no significant difference (P 0.05). The average CT value and image noise of coronary artery in group C were the highest, and there was significant difference between the two groups (P 0.05). The SNR and CNR of coronary artery in the five groups were compared. There was no significant difference (P 0.05). The radiation dose of group C was the lowest, and the difference was statistically significant (P 0.05).
(3) The image quality of the three groups were (3.51+0.70), (3.49+0.33) and (3.55+0.47) respectively, with no significant difference (P 0.05); the average CT value, image noise, SNR and CNR of the three groups were statistically significant (P 0.05); the average CT value of group A and group B (or group C) were significantly different (P 0.05), and the average CT value of group A was the highest (P 0.05). The difference of image noise, SNR and CNR between group A and group B (or group C) was statistically significant (P 0.05), and the difference of image noise, SNR and CNR between group A and group C was not statistically significant (P 0.05); the difference of radiation dose between group A and group B (or group C) was statistically significant (P 0.05), and the radiation dose of group B (or group C) was about 34% lower than that of group A.
conclusion
(1) For patients with BMI in the normal range, coronary CTA with 80 kV or 100 kV tube voltage can significantly reduce radiation dose while ensuring image quality.
(2) For patients with BMI in the normal range, coronary CTA can be performed by simultaneously opening CARE kV and CARE Dose 4D (reference voltage 100 kV, reference current 400 mAs) to obtain high quality images and significantly reduce radiation dose.
(3) For overweight patients, 100 kV tube voltage combined with original data-based reconstruction (SAFIRE) for coronary CTA can improve image quality and significantly reduce radiation dose.
The second part is the clinical application of dual source CT low contrast injection in coronary artery imaging.
objective
(1) To investigate the value of 270 mg I/ml iodine-containing contrast medium combined with 100 kV tube voltage scanning in coronary CTA by using three different concentrations of contrast medium under DSCT 100 kV tube voltage.
(2) To evaluate the image quality of three contrast agent injection schemes under different tube voltages in coronary CTA, and to explore the feasibility of low dose and rate contrast agent injection schemes combined with different tube voltages in coronary CTA.
Materials and methods
(1) 120 patients undergoing DSCT coronary angiography were randomly divided into three groups. BMI was within normal range. Contrast agents of 370 mg I/ml, 320 mg I/ml and 270 mg I/ml were used to contrast the coronary artery with the same injection rate (5 ml/s). The display rate of coronary artery branches, the average CT value of each region of interest, image noise, SNR and CNR were performed. Comparative analysis.
(2) 120 patients who underwent DSCT coronary angiography were randomly divided into 3 groups. BMI was within normal range. Three different contrast medium injection schemes were used to enhance the scan. In group A, the tube voltage was 120 kV, the contrast medium was 70 ml, the saline was 30 ml, the injection rate was 5.0 ml/s; in group B, the tube voltage was 100 kV, the contrast medium was 60 ml, and the saline was 30 ml. The artifacts of superior vena cava (SVC) and right ventricle (RV) were evaluated in three groups, and the display rate of coronary artery branches, mean CT value of each region of interest, image noise, SNR and CNR were compared and analyzed.
Result
(1) The displaying rate of four main branches of coronary artery in three groups was 100%. There was no significant difference in the displaying rate of other small branches (P 0.05). The mean CT values of AAO, DAO, LM, RCA, LAD, LM and LCX in three groups were significantly different (P 0.05). The mean CT values of 370 groups were the highest, and the mean CT values of 270 groups were the lowest. There was no significant difference in mean CT value, image noise, SNR and CNR of ventricular wall (LVW). There was no significant difference in radiation dose among the three groups (P 0.05).
(2) The ratio of superior vena cava and right ventricular artifacts in group A was significantly higher than that in group B and group C, and the difference was statistically significant (P 0.05). There was no significant difference between the two groups in the ratio of superior vena cava and right ventricular artifacts between group B and group C (P 0.05). There was no significant difference among the three groups (P 0.05). The difference of coronary image noise among the three groups was statistically significant (P 0.05). The highest noise was found in group C. There was no significant difference between the three groups in coronary SNR and CNR (P 0.05). There was no significant difference in LVW among the three groups (P 0.05). There was significant difference in radiation dose among the three groups (P 0.05).
conclusion
(1) For patients with BMI in the normal range, 100 kV catheter voltage combined with 270 mg I/ml iodine-containing contrast medium for coronary CTA can ensure the image quality and achieve "double low dose" effect.
(2) For patients with BMI in the normal range, different tube voltages (80kV, 100kV and 120kV) scanning combined with different dosage regimens for coronary CTA examination can not only ensure the image quality but also reduce the harm of contrast medium to the patients, thus playing a "double low dose" effect.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R816.2
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 吳愛(ài)琴;鄭文龍;許崇永;;MSCT CARE Dose 4D功能與螺距對(duì)圖像噪聲和輻射劑量的影響[J];放射學(xué)實(shí)踐;2010年09期
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