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不同辐射剂量心脏冠状动脉多层螺旋CT成像的比较
引用本文:曹瑜, 张永县. 不同辐射剂量心脏冠状动脉多层螺旋CT成像的比较[J]. CT理论与应用研究, 2016, 25(1): 95-101. DOI: 10.15953/j.1004-4140.2016.25.01.12
作者姓名:曹瑜  张永县
作者单位:1.首都医科大学附属北京同仁医院放射科, 北京 100730
摘    要:目的:探讨不同辐射剂量扫描方法在心脏冠状动脉多层螺旋CT成像中的效果。方法:将我院自2013年1月至2015年3月间心内科按照拟定排除标准的150例患者作为研究对象,随机分为3组,每组各50例,其中第1组作为对照组,使用常规回顾性心电门控;第2组为观察A组,使用前瞻性心电门控;第3组为观察B组,使用基于BMI优化管电流回顾性心电门控。3组患者均120 k V管电压扫描。使用370 mg I/m L非离子型碘对比剂碘普罗胺(碘海醇)。记录每组患者一般资料,测量原始轴位图像上各区的CT值,计算出各自强化的平均值,测量胸大肌的CT值,测算客观分析指标SNR、CNR和BN,并进行主观评价。对所获取的主客观指标进行统计学分析。结果:3组客观分析指标SNR、CNR、BN及主观指标RCA、LM、LAD、LCX为:对照组SNR(15.45±3.78),CNR(13.27±3.49),BR(30.44±5.53);RCA(3.62±0.54),LM(3.84±0.39),LAD(3.72±0.42);LCX(3.49±0.48),均值(3.63±0.42);观察A组SNR(15.08±3.05),CNR(13.03±2.91),BR(30.93±4.52);RCA(3.61±0.52),LM(3.82±0.42),LAD(3.68±0.49);LCX(3.52±0.51),均值(3.62±0.44);观察B组SNR(14.43±2.71),CNR(12.38±2.54),BR(32.06±3.61);RCA(3.60±0.51),LM(3.79±0.41),LAD(3.64±0.47);LCX(3.48±0.49),均值(3.59±0.43)。观察A组和观察B组以及对照组两两比较差异不显著(0.05);观察A组和观察B组的辐射剂量指标CTDI
关 键 词:多层螺旋CT  冠状动脉  血管造影  辐射剂量
收稿时间:2015-07-28

Comparison of Multi-slice Spiral CT Imaging for Cardiac Coronary Arteries with Different Radiation Doses
CAO Yu, ZHANG Yong-xian. Comparison of Multi-slice Spiral CT Imaging for Cardiac Coronary Arteries with Different Radiation Doses[J]. CT Theory and Applications, 2016, 25(1): 95-101. DOI: 10.15953/j.1004-4140.2016.25.01.12
Authors:CAO Yu  ZHANG Yong-xian
Affiliation:1.Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Abstract:Objective: To investigate the effect of different radiation dose scanning methods in the multi slice spiral CT imaging of the heart. Methods: in our hospital from January 2013 to 2015 March between Department of Cardiology in accordance with the proposed exclusion criteria of 150 patients as the research object, randomly assigned to three groups, each with 50 cases in each, in which the group 1 as control group, using retrospective ECG gating; the two groups were observed in group a, using prospective ECG gating; group 3 as observed in the B group using based on BMI optimization tube current and retrospective ECG gating. 3 groups of patients were 120 k V tube voltage scan. The use of 370 mg I/m L nonionic iodine contrast agent(iodide). Record in each group of patients with general information and measurements of original axial images in various parts of the CT value, calculate the average value of their enhanced, CT value measurement of pectoralis major, objective index analysis of SNR, CNR and BN measurement and subjective evaluation. Statistical analysis of the obtained subjective and objective indicators. Results: the three groups of objective analysis indicators SNR, CNR, BN and subjective index of RCA, LM, LAD, LCX is: the control group SNR(15.45/3.78), CNR(13.27/3.49), BR(30.44 5.53); RCA(3.62/0.54), LM(3.84/0.39), the LAD(3.72 0.42); LCX(3.49/0.48), average(3.63 0.42); Observation group A SNR(15.08/3.05), CNR(13.03/2.91), BR(30.93 4.52); RCA(3.61/0.52), LM(3.82/0.42), the LAD(3.68 0.49); LCX(3.52/0.51), average(3.62 0.44); Observation group B SNR(14.43/2.71), CNR(12.38/2.54), BR(32.06 3.61); RCA(3.60/ 0.51), LM(3.79/0.41), the LAD(3.64 0.47); LCX(3.48/0.49), average(3.59/0.43). Observe group A and group B and control group in two comparative difference was not significant(P>0.05); Observe group A and group B radiation dose index CTDIVOL, DLP, ED value are: control group CTDIVOL(57.29/2.17), DLP(1025.37/65.38), ED(14.35 0.98); Group A: CTDIVOL(19.86/1.45), DLP(256.84/25.93), ED(3.56 0.34); Group B: CTDIVOL(29.84/6.19), DLP(513.54/98.43), ED(7.17/1.39). Group A was significantly lower than the control group(0.015, 0.031, 0.015, 0.031, 0.094); Group B was significantly lower than the control group(0.015, 0.031, 0.015, 0.031, 0.044); Which observe the indicators of group A was significantly lower than group B(0.014, 0.016, 0.014, 0.016, 0.012). Conclusion: using 256 layer spiral CT prospective heart switch control and switch control method based on BMI optimization were retrospectively heart can full figure in the process of coronary artery imaging diagnostic image quality and significantly reduce the radiation dose, the prospective heart than BMI optimization control technology of switch tube current retrospective heart switch control method effect is more obvious. 
Keywords:multi slice spiral CT  coronary artery  angiography  radiation dosage
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