摘要
目的探讨自动管电压调制技术(Auto-kV)及Clear View+迭代算法在降低主动脉CT血管造影(CTA)检查对比剂用量以及辐射剂量的可行性。方法前瞻性搜集本院2018年3月至7月临床疑诊主动脉病变行主动脉CTA检查的60例患者,随机分为两组,A组30例,采用Auto-kV,60~140 kV,Clear View+70%迭代重组。B组30例,管电压120 kV,自动管电流技术(参考管电流150 mAs),滤波反投影法(FBP)重组。A组根据不同的管电压给予不同的低对比剂用量及流率。B组注射常规对比剂用量及流率(60 ml,4.5 ml/s)。主观评价由两名高年资放射科医师采用双盲法进行5分制评价。测量主动脉感兴趣区(ROI)的CT值及噪声(SD)值,并计算信噪比(SNR)及对比噪声比(CNR)。记录两组的对比剂用量及辐射剂量[CT容积剂量指数(CTDIvol),剂量长度乘积(DLP)和有效辐射剂量(ED)]。结果两组患者年龄、性别、身高、体重、身体质量指数(BMI)和扫描长度均无统计学差异(P>0.05)。两组图像质量主观评分均满足临床诊断需求,且无统计学差异(P>0.05)。A组27例(90%)患者低电压扫描(100 kV 10例,80 kV 14例,70 kV 3例)。两组主动脉的不同ROI CT值均>300 HU,无统计学差异(P>0.05)。图像质量客观评价指标A组(SD:13.78±1.54,SNR:28.74±4.83,CNR:36.48±5.35)优于B组(SD:21.63±4.60,SNR:18.07±5.48,CNR:23.79±6.65)(P<0.05)。A组与B组辐射剂量评价指标CTDIvol(5.08±1.91 vs.13.29±1.71)mGy,DLP(330.66±125.31 vs.866.73±122.29)mGy·cm和ED(4.95±1.88 vs.12.42±1.76)mSv有统计学差异(P<0.05)。A组较B组对比剂用量及辐射剂量降低平均达27.08%及60.14%。结论Auto-kV联合Clear View+迭代算法使主动脉CTA检查实现了患者个性化的扫描及对比剂注射方案。提升图像质量的同时,降低了对比剂用量以及辐射剂量。
Objective To explore the feasibility of auto-kV combined with Clear View+iterative algorithm in aorta CTA for contrast medium volume and radiation dose reduction.Methods Sixty patients with suspected aortic disease and underwent aortic CTA examination from March to July 2018 were included and randomly divided into two groups.Auto-kV and Clear View+70%was applied in group A.The scan parameters of group B were tube voltage of 120 kV,automatic tube current technology(reference current:150 mAs),and filtered back projection reconstruction.kV-targeted low contrast volume and flow rate was injected in group A.In group B,60 ml contrast medium was injected with the flow rate of 4.5 ml/s.The subjective evaluation of image quality was evaluated on a five-point scale by two senior radiologists using a double-blind method.CT values and noise values(SD)on different regions of interest of aorta were measured,meanwhile SNR and CNR were calculated.The contrast dosage and radiation dose indexes(CTDIvol,DLP and ED)were recorded.Results There was no significant difference in the distribution of age,gender,height,weight,body mass index and scan length between the two groups(P>0.05).The subjective image quality scores of both groups met the clinical diagnostic needs,and there was no statistical difference(P>0.05).Low tube voltage scan was performed in 27 patients(90%)in group A(100 kV:10 cases,80 kV:14 cases and 70 kV:3 cases).The CT values of the two groups were more than 300 HU,and there was no statistical difference(P>0.05).Objective evaluation of image quality in group A(SD:13.36±1.37,SNR:28.74±4.83,CNR:36.48±5.35)was superior to group B(SD:21.63±4.60,SNR:18.07±5.48,CNR:23.79±6.65)(P<0.05).CTDIvol(5.08±1.91 vs.13.29±1.71)mGy,DLP(330.66±125.31 vs.866.73±122.29)mGy·cm and ED(4.95±1.88 vs.12.42±1.76)mSv showed significant difference(P<0.05)in group A and group B.Compared with group B,the contrast medium volume and radiation dose in group A decreased by 27.08%and 60.14%,respectively.Conclusion Auto-kV combined with Clear View+iterative algorithm could enable aortic CTA examination to attain personalized scan parameters and contrast medium injection protocols.The image quality was improved while the contrast medium volume and radiation dose were reduced because of Auto-kV combined with Clear View+iterative algorithm.
作者
牛丹丹
李莹
张颖颖
杨晨晓
王君鑫
王乃武
于敏
贾守强
NIU Dandan;LI Ying;ZHANG Yingying(Department of Imaging,Jinan People’s Hospital,Jinan 271100,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第5期999-1003,共5页
Journal of Clinical Radiology
