Force CT 70 kV联合270 mgI/ml低浓度碘克沙醇对比剂在冠状动脉CT造影检查中的初步应用

Preliminary application of force CT 70 kV combined with 270 mgI/ml low concentration contrast agent in CCTA examination

目的探讨Force CT 70 kV低管电压联合270 mgI/ml低浓度碘克沙醇对比剂和3.5 ml/s低流率的三低扫描方案在冠状动脉CT造影(CCTA)检查中的初步应用.方法收集80例患者,年龄28~80岁,心率:60~120次/min,律齐,体质量指数(BMI)18.5~22.9 kg/m^2.分为A、B 2组,A组40例为双低组,B组40例为常规组.扫描条件:A组采用管电压70 kV,开启智能管电流调控技术(参考管电流390 mAs),对比剂采用270 mgI/ml.B组管电压采用120 V,开启智能管电流调控技术(参考管电流390 mAs),对比剂采用350 mgI/ml.对2组图像主观评价、客观评价指标[血管CT值、图像噪声、信号噪声比(SNR)、对比噪声比(CNR)及辐射剂量、碘总量]进行对比分析.应用SPSS 19.0统计软件对数据进行分析.结果 A组DLP:23.9±2.8、CDTI:1.55±0.26、ED:0.32±0.10.B组DLP:35.3±5.3、CDTI:1.89±0.28、ED:0.57±0.15.A组较B组辐射剂量下降47.36%,组间差异均具有统计学意义(P<0.05).双低组的辐射剂量显著低于对照组,CTDIvol、DLP、ED分别下降了17.99%、32.24%、47.37%,同时,双低组碘摄入量较常规组也降低了22.86%.结论 Siemens Somatom Force第3代双源CT超低管电压、低浓度对比剂联合ADMIRE重建技术扫描方案在BMI较低人群中,可以获得更好的图像质量,在保证良好图像质量的情况下,显著降低了辐射剂量和碘摄入量,从而为临床提供了一种更为安全可行的冠状动脉检查方法.

Objective To explore the preliminary application of Force CT 70 kV low tube voltage combined with 270 mgI/ml low concentration contrast agent and 3.5 ml/s low current scanning scheme in CCTA examination.Methods Eighty patients, aged 28~80 years, with heart rate of 60~120 beats per minute, neat rhythm, body mass index(BMI) of 18.5~22.9 were collected. They were randomly divided into group A and group B. Forty cases in group A were double-low group and 40 cases in group B were conventional group. Scanning conditions: group A used 70 kV tube voltage, open intelligent tube current control technology(reference tube current 390 mAs), and 270 mgI/ml contrast agent. The voltage of group B is 120 V, the current control technology of intelligent tube is turned on(reference tube current is 390 mAs), and the contrast agent is 350 mgI/ml. The subjective evaluation, objective evaluation index[CT value, image noise, signal-to-noise ratio(SNR), contrast-to-noise ratio(CNR), radiation dose and total iodine of the two groups] were compared and analyzed. SPSS 19.0 statistical software was used to analyze the data. Results Of the 80 patients who underwent CCTA examination, 80 patients successfully completed CCTA examination. The average DLP of group A was(23.9±2.8), CDTI was(1.55±0.26), ED was(0.32±0.10). The average DLP, CDTI and ED in group B were(35.3±5.3),(1.89±0.28) and(0.57±0.15). The average radiation dose of group A was 47.36% lower than that of group B, with statistical significance(P<0.05). The radiation dose of the double-low group was significantly lower than that of the control group. CTDIvol, DLP and ED decreased by 17.99%,32.24% and 47.37% respectively.Meanwhile, iodine intake of the double-low group was 22.86% lower than that of the conventional group. Conclusion Siemens Somatom Force 3 rd-generation dual-source CT scanning scheme with ultra-low tube voltage, low concentration contrast agent and ADMIRE reconstruction technology can obtain better image quality in low BMI population.Under the condition of ensuring good image quality, radiation dose and iodine intake are significantly reduced, thus providing a safer clinical application. Feasible method of coronary artery examination.