不同剂量胸部CT扫描对起搏器植入患者的影响

The effect of chest CT scan of different dose on the patients with pacemaker implantation

目的探讨不同剂量胸部CT扫描对起搏器植入患者的影响。方法回顾性分析2015年8月~2017年8月在宝鸡市中医医院行CT冠状动脉造影起搏器植入患者152例的临床资料,根据CT剂量的不同分为常规剂量组(76例)和低剂量组(76例)。所有患者均使用GE公司生产的64排128层OPTIMA CT660扫描仪,其中常规剂量组参数设置为电压120 V,CARE Dose 4D,电流150 mA,螺距1.0,层厚5.0 mm,层距5.0 mm,冲击矩阵为512×512;低剂量组参数设置除电流30 mA外,其余方法同常规剂量组。比较两组患者的图像质量及辐射剂量。结果常规剂量组的肺窗图像及纵隔窗图像血管均显示良好,金属无伪影,周围组织清晰,低剂量组的肺窗图像及纵隔窗图像伴有轻度的金属伪影,边缘虽模糊,但周围组织依然可见。两组CT图像质量评分的血管数分布差异无统计学意义(P>0.05)。两组患者CT剂量指数(CT-DI)、剂量长度乘积(DLP)、有效剂量(ED)比较,低剂量组均低于常规剂量组,差异有统计学意义(P<0.05)。结论起搏器植入患者行胸部CT扫描时,常规剂量及低剂量均能提供优秀的图像质量,在病例资料大致等同的情况下,相较于常规剂量,起搏器植入患者的低剂量胸部CT扫描具有更广的心率适用性和相对较低辐射剂量,建议推广。

Objective To explore the effect of chest CT scan of different dose on the patients with pacemaker implantation. Methods The clinical data of 152 patients with pacemaker implantation with CT coronary angiography in Baoji Hospital of Traditional Chinese Medicine from August 2015 to August 2017 were analyzed retrospectively. According to the different dose for CT scan , the patients were divided into conventional dose group （76 cases） and low dose group （76 cases）. All used the OPTIMA CT660 scanners of 64 row 128 layers produced by GE, the parameters of conventional dose group were set of voltage 120 V, CARE Dose 4D, current 150 mA, pitch 1.0, layer thickness 5.0 mm, layer distance 5.0 mm, impact matrix 512×512. The parameters of low dose group were set of except current 30 mA, the remaining parameters were as same as the conventional dose group. The image quality and radiation dose of the two groups were compared. Results The pulmonary image and mediastinum window image in conventional dose group showed good blood vessels without metal artifacts, the surrounding tissue was clear. The pulmonary images and mediastinum window image in the low dose group showed that with mild metal artifacts, edges were fuzzy, and still visible from the surrounding tissue. There was no significant difference in the vascular distribution of CT image quality scores between the two groups （P 〉 0.05）. CT dose irldex （CT- DI）, dose-length product （DLP） and effective dose （ED） were compared between the two groups, the low dose group were lower than those in the conventional dose group, with statistically significant difference （P 〈 0.05）. Conclusion For the pacemaker implantation patients with chest CT scans, the conventional dose and low dose of CT scans can provide excellent image quality. In the case of approximately the same case data, the low dose chest CT scan in patients with pacemaker implantation has a wider heart rate applicability compared to the conventional dose, which is worth of clinical application.