ISSN 1004-4140
CN 11-3017/P

“双低”技术在主动脉CTA中的可行性研究

The Application of Low Tube Voltage and Low Volume Contrast Agent Protocol in Aorta CTA

  • 摘要: 目的:评价“双低”技术在主动脉CT血管造影(CTA)中的图像质量和辐射剂量,探讨其临床应用可行性。方法:前瞻性将90例临床似诊为主动脉疾病患者随机分为常规组和双低组(n=45)。常规组:120kVp、对比剂量1.5mL/kg(浓度350mgI/mL)。双低组:100kVp、对比剂量1.0mL/kg(浓度300mgI/mL)。两组的其他扫描参数相同,开启自动管电流调制(ATCM)和Smart prep技术。读取CTA剂量报告中的CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP);记录每位患者对比剂用量并计算碘含量。由2位副主任医师对图像质量进行主观和客观评价,评价内容包括:靶血管和背景的CT值,图像的信噪比(SNR)及对比噪声比(CNR),主动脉及分支血管显示情况和血管锐利程度。采取两独立样本t检验来比较两组的临床资料、辐射剂量、碘含量、图像质量的主观及客观评价等指标。结果:两组在年龄、身高、身体质量指数(BMI)均无统计学差异(P>0.05)。双低组患者接受辐射剂量和碘含量均明显低于常规组,两组差异有明显统计学意义(P<0.05)。两组图像的主观评价差异无统计学意义(P>0.05)。客观评价:两组在主动脉主干及分支的CT值均>300HU,之间差异不具有统计学意义(P>0.05);两组SNR、CNR之间差异不具有统计学意义(P>0.05),双低组图像噪声略高于常规组,噪声在诊断范围内。结论:应用100kVp、对比剂量1.0mL/kg(浓度300mgI/mL),结合ATCM技术在主动脉CTA检查是可行的,优势是有效降低了辐射剂量和对比剂碘量,同时能满足临床诊断要求。

     

    Abstract: Objective: To evaluate the effect and its feasibility in clinical application of double-low technology(the low tube voltage and low volume contrast agent protocol) for aorta CT Angiography(CTA) on the image quality and radiation dose. Method: Totally 90 continuous patients with clinically suspected aortic lesion underwent aorta CT Angiography. They were randomly divided into two groups(control group and double low group) based on different scan protocol, prospectively. Control group included 45 patients using following parameters: tube voltage 120 kVP and contrast agent volume 1.5 mL/kg(consentration: 350 mg I/m L). Double low group included 45 patients using following parameters: tube voltage 100 kVP and contrast agent volume 1.0 mL/kg(consentration: 300 mg I/m L). Other scanning parameters were same and all subjects were used automatic tube current modulation(ATCM) technology and Smart prep technology. CT dose volume index(CTDIvol) and dose length product(DLP) in the CTA dose report were read and the dosage of contrast agent and its iodine contrast agent volume were recorded. Two associate chief radiologists evaluated the image quality and its contents consisted of the average CT values of the targeted vessels and background, image signal-to-noise ratio(SNR), contrast to noise ratio(CNR), the display and sharpness of aortic and its major branches. The clinical information, radiation dose, iodine contrast agent volume, objective and subjective assessment of image quality of these two groups were analyzed by independent t test. Results: The differences of sex, age and body mass index(BMI) of two groups were not statistically significant(P<0.05). The radiation dose and the volume of iodine received in double low group was significantly lower than that of control group, with significant statistic difference(P<0.05). The difference of subjective assessment score of image quality in two groups was not statistically significant(P>0.05). The average CT values of the aortic trunk and its major branches in two groups were higher than 300 HU, with no significant statistic difference(P>0.05). The differences of SNR and CNR in two groups were not statistically significant also(P>0.05). Although image noise in double low group was slightly higher than that of control group, there is no influence on clinical diagnosis. Conclusion: Aorta CT angiography using 100 kVP as tube voltage, contrast agent volume 1.0 mL/kg(consentration: 300 mg I/m L) and automatic tube current modulation(ATCM) technology was feasible, which can effectively reduce the radiation dose and the volume of iodine contrast agent and meet the needs of clinical diagnosis at the same time.

     

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