CARE Dose 4D技术联合低kV及低剂量对比剂在MSCT头颈CTA应用

Dose 4D CARE Technology Combined with Low kV and Low Dose Contrast Agent in MSCT Head and Neck Vascular Imaging Applications

目的:探讨128层螺旋CT头颈部血管成像(CTA)应用CARE Dose 4D技术联合低剂量对比剂优化扫描方案的可行性及价值。方法:前瞻性选取接受头颈部血管成像检查的60例患者,随机分为对照组(A组)和双低剂量组(B组),每组各30例。对照组(A组)管电压120 kV,采用CARE Dose 4D技术参考管电流120 mA,对比剂用量65 mL;双低剂量组(B组)管电压80 kV,采用CARE Dose 4D技术参考管电流120 mA,对比剂用量45 mL。测量双侧颈总动脉、双侧颈内动脉及双侧大脑中动脉M1段CT值、噪声、信噪比(SNR)进行客观图像质量评价。由两名高年资主治医师采用双盲法进行图像质量评分评价。对比A组与B组间辐射剂量。结果:两名主治医师对动脉图像量质评分的一致性较高(Kappa=0.782,P<0.05)。两组动脉图像质量评分、SNR比较,差异无统计学意义(P>0.05)。双低剂量组各动脉强化CT值均高于对照组;双低剂量组容积CT剂量指数、剂量长度乘积和有效剂量均明显低于对照组;差异均具有统计学意义(P<0.05)。结论:128层MSCT头颈血管成像应用低kV及CARE Dose 4D技术联合低剂量对比剂扫描方案,不仅辐射剂量降低68%,同时造影剂用量降低30.7%,降低对比剂危害风险并节省费用,保证诊断图像质量值得临床推广。

Objective： To investigate the feasibility and value of 128 slice spiral CT angiography （CTA） using CARE Dose 4D techniques combined with low dose contrast agent to optimize the scanning protocol. Methods： a total of 60 patients with head and neck vascular imaging were selected and randomly divided into control group （A group） and low dose group （B group）, each group with a total of 30 cases. The control group （A group） 120 kV tube voltage, using CARE Dose4D technology reference tube current of 120 mA, dosage of contrast agent was 65 ml; double low dose group （B group） tube voltage 80 kV, using CARE Dose4D technology reference tube current of 120 mA, contrast agent dosage is 45 ml. Objective to evaluate the image quality of CT, noise and signal to noise ratio （SNR） of bilateral common carotid artery, bilateral internal carotid artery and bilateral middle cerebral artery （M1）. The evaluation of image quality was performed by two double blind methods. Comparison of radiation dose between group A and group B. Results： two attending physicians had a higher consistency of P 〈 0.05 （Kappa = 0.782）. There was no significant difference between the two groups in arterial image quality score and SNR score （P 〉 0.05）. The double low dose group arterial enhancement CT value were higher than the control group; double low dose volume CT dose index and dose length product and effective dose were significantly lower than the control group; the differences were statistically significant （P 〈 0.05）. Conclusion： low kV imaging using 128 slice MSCT and CARE Dose 4D head and neck vascular technique combined with low dose contrast scanning scheme, not only reduce the radiation dose of 68%, while the amount of contrast agent is reduced by 30.7%, reduce the contrast agent risk and cost savings, ensure the diagnostic image quality is worthy of promotion.