心房颤动患者导管消融术不同管电流CT扫描方案对患者辐射剂量影响研究

Study on the influence of Different Tube Current CT Scanning Protocols on Radiation Dose in Patients with Atrial Fibrillation

目的研究心房颤动患者导管消融术不同管电流电子计算机断层扫描(CT)扫描方案对患者辐射剂量的影响。方法回顾性分析2020年7月至2022年11月于我院进行导管消融术治疗的133例心房颤动患者临床资料,根据患者胸部CT扫描管电流水平将其分为微管电流组(管电流为30mAs)、低管电流组(管电流为50mAs)、中管电流组(管电流为100mAs)和高管电流组(管电流为200mAs),四组例数分别为30例、37例、34例、32例。记录四组患者辐射剂量[CT剂量指数(CTDI)、CT剂量长度乘积(DLP)、有效辐射剂量(ED)]、客观图像质量[CT值、对比噪声比(CNR)、信噪比(SNR)]、主观图像质量[解剖结构显示、噪声、图像清晰度]、左心房(LA)直径、LA憩室显示率、肺静脉(PV)解剖变异显示率。结果四组辐射剂量比较差异有统计学意义(P<0.05),其中微管电流组CTDI、DLP、ED均低于低、中、高管电流组(P<0.05),低管电流组CTDI、DLP、ED均低于中、高管电流组(P<0.05),中管电流组CTDI、DLP、ED均低于高管电流组(P<0.05)。微管电流组LA、左上肺静脉(LSPV)及右上肺静脉(RSPV)的CT值、SNR、CNR均低于低、中、高管电流组(P<0.05),低、中、高管电流组LA、LSPV及RSPV的CT值、SNR、CNR比较差异均无统计学意义(P>0.05)。微管电流组解剖结构显示、噪声及图像清晰度评分均低于低、中、高管电流组(P<0.05),低、中、高管电流组解剖结构显示、噪声及图像清晰度比较差异均无统计学意义(P>0.05)。微管电流组LA直径、LA憩室显示率及PV解剖变异显示率均低于其他三组(P<0.05),低、中、高管电流组LA直径、LA憩室显示率及PV解剖变异显示率比较差异均无统计学意义(P>0.05)。结论与100mAs、200mAs管电流相比,心房颤动患者导管消融术采用50mAs管电流CT扫描辐射剂量明显较少,所获图像质量也能够达到相关标准。

Objective To study the effect of different tube current computed tomography(CT)scanning protocols on radiation dose in patients with atrial fibrillation.Methods The clinical data of 133 patients with atrial fibrillation who underwent catheter ablation in our hospital from July 2020 to November 2022 were retrospectively analyzed.According to the tube current level of chest CT scan,patients were divided into microtubule current group(tube current is 30mAs),low tube current group(tube current is 50mAs),medium tube current group(tube current is 100mAs)and senior management current group(tube current is 200mAs),with 30 cases,37 cases,34 cases and 32 cases respectively.Radiation dose[CT dose index(CTDI),CT dose length product(DLP),effective radiation dose(ED)],objective image quality[CT value,contrast-noise ratio(CNR),signal-to-noise ratio(SNR)],subjective image quality[anatomical structure display,noise,image definition],left atrium(LA)diameter,LA diverticulum were recorded in the four groups of patients Display rate,display rate of pulmonary vein(PV)anatomic variation.Results The difference of radiation dose between the four groups was statistically significant(P<0.05).CTDI,DLP and ED in the microtubule current group were lower than those in the low,medium and senior management current groups(P<0.05),and CTDI,DLP and ED in the low tube current group were lower than those in the middle and senior management current groups(P<0.05).CTDI,DLP and ED in middle tube current group were lower than those in senior management current group(P<0.05).The CT values,SNR and CNR of LA,left superior pulmonary vein(LSPV)and right superior pulmonary vein(RSPV)in microtubule current group were lower than those in low,medium and senior management current groups(P<0.05),but there were no significant differences in CT values,SNR and CNR of LA,LSPV and RSPV in low,medium and senior management current groups(P>0.05).The anatomical structure display,noise and image clarity scores of microtubule current group were lower than those of low,medium and senior management current groups(P<0.05),but there were no significant differences in anatomical structure display,noise and image clarity among low,medium and senior management current groups(P>0.05).The LA diameter,LA diverticulum display rate and PV anatomical variation display rate in the microtubule current group were lower than those in the other three groups(P<0.05).There were no significant differences in the LA diameter,LA diverticulum display rate and PV anatomical variation display rate in the low,medium and senior current groups(P>0.05).Conclusion Compared with 100mAs and 200mAs tube current,the radiation dose of CT scan with 50mAs tube current in catheter ablation for patients with atrial fibrillation is significantly lower,and the image quality obtained can also meet relevant standards.