低碘浓度对比剂在老年患者冠脉CT血管造影中的可行性分析

Feasibility analysis of low concentration of iodine contrast agent in coronary CT angiography in elderly patients

目的探讨不同碘浓度对比剂对于老年患者冠脉CT血管造影(coronary CT angiography,CCTA)图像质量的影响。方法回顾性分析2021年10月至2021年12月于复旦大学附属华东医院临床疑诊为冠心病需做CCTA检查的72例老年患者,根据患者所使用的碘对比剂浓度不同(350 mgI/ml vs.320 mgI/ml)分为A、B两组,比较两组图像客观、主观图像质量,以及辐射剂量。结果A组所有冠脉节段平均CT值均大于B组,差异有统计学意义(P<0.05),A组图像噪声(30.63±4.49)显著高于B组(27.64±5.37),差异有统计学意义(P<0.05)。两组图像信噪比、对比噪声比、以及辐射剂量均不存在显著差异。结论在碘对比剂注射方案相同的情况下,低浓度碘对比剂(威视派克,320 mgI/mL)与较高浓度的碘对比剂(碘比醇,350 mgI/mL)相比,并未降低CCTA图像质量,同时降低了老年患者的碘摄入量,可作为临床推广。

Objective To explore the effects of different concentration of iodine contrast agents on the image quality of coronary CT angiography(CCTA) in elderly patients.Methods 72 elderly patients with suspected coronary heart disease who needed CCTA examination in Huadong hospital affiliated to Fudan university from October 2021 to December 2021 were retrospectively analyzed.They were divided into group A and group B according to the iodine contrast concentration used(350 mgI/mL vs.320 mgI/mL).The objective and subjective image quality and radiation dose were compared between the two groups.Results The average CT values of all coronary segments in the group A were higher than those in the group B(P<0.05),and the image noise in the group A(30.63±4.49) was significantly higher than that in the group B(27.64±5.37)(P<0.05).There were no significant differences in signal to noise ratio,contrast to noise ratio and radiation dose between the two groups.Conclusion Under the same iodine contrast injection protocol,low concentration of iodine contrast agent(iodixanol,320 mgI/mL) does not reduce the image quality of CCTA compared with higher concentration of iodine contrast agent(iobitridol,350 mgI/mL),and at the same time,it can reduce the iodine intake of elderly patients,which can be popularized in clinical practice.