摘要
目的多模态技术为窄采集窗、等中心、低管电压、低管电流联合迭代重建技术,探讨多模态技术在降低超重、肥胖患者多层螺旋CT冠状动脉血管成像(MSCTCA)辐射剂量中的价值。方法收集广东省中医院珠海医院2020年11月至2021年8月行MSCTCA检查64例超重、肥胖患者(BMI﹥25kg/m~2),采用前瞻性随机对照研究,随机分多模态组(A组)、常规组(B组),各32例。A组:等中心位置、管电压80Kv、智能毫安的80%,心动PR周期的60%~80%;B组:常规位置,管电压100Kv、电流为智能毫安,心动PR周期的30%~80%。比较A、B组容积CT剂量指数(CTDvol)、剂量长度乘积(DLP)、辐射剂量(ED)、MSCTCA图像的客观图像质量指标:噪声、信噪比(SNR)、对比信噪比(CNR)及Likert 5分主观质量评分。结果A、B组的ED分别为(1.43±0.46)mSv、(5.44±1.33)mSv;A、B两组CTDvol、DLP、ED差异有统计学意义(P﹤0.01)。A、B两组噪声、SNR、CNR,后者优于前者(P﹤0.01)。A、B两组主观质量评分4.37±0.69分、4.40±0.67分,差异无统计学意义(P=0.46),主观评分一致性ICC较好(ICC=0.78,0.97)。两组冠状动脉主观评分优秀、良好总和率≥92.18%,可评价血管≥98.62%。A、B两组诊断高危斑块的效果无差别(P﹤0.01)。结论在满足临床诊断需求情况下,多模态技术能降低超重、肥胖患者MSCTCA的ED。
Objective To explore the value of multi-modality technology,a joint iterative reconstruction technique with a narrow acquisition window,isocenter,low tube voltage,and low tube current,in reducing the radiation dose in multi-slice spiral computed tomography coronary angiography(MSCTCA)in overweight and obese patients.Methods 64 overweight and obese patients(BMI﹥25 kg/m~2)who underwent MSCTCA from November 2020 to August 2021 at Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine were collected in a prospective randomized controlled study and randomly divided into the multi-modality-normal group(group A)and conventional-normal group(group B),32 cases each.The parameters in the A groups were isocentric scan,tube voltage of 80 kV,tube current control using 80%“smart milliampere”,and maximum current between 60%and 80%of the RR interval.The parameters in the B groups were normal position,tube voltage of 100k V,tube current control using smart milliampere,and maximum current ranging from 30%to 80%of the RR interval.The Computed Tomography dose index volume(CTDIvol),dose length product(DLP),effective radiation dose(ED),objective image quality(IQ),noise,signal-to-noise ratio(SNR),contrast signal-to-noise ratio(CNR),and subjective 5-point Likert scale IQ scores of MSCTCA images were compared among the two groups.Results The EDs of groups A and B were(1.43±0.46)mSv and(5.44±1.33)mSv respectively,in addition,the variations in CTDvol,DLP,and ED between groups A and B were statistically significant(P﹤0.01).The results suggested that noise,SNR,and CNR of groups A were better than those of group B(P﹤0.01).The subjective quality scores of the A and B groups were 4.37±0.69 and 4.40±0.67,indicating the difference was not statistically significant(P=0.46)and the subjective score consistency ICC was better(ICC=0.78,0.97).The total rate of excellent and good coronary subjective scores in the two groups was greater than 92.18%,and the evaluable blood vessels exceeded 98.62%.There was no difference in the effectiveness of diagnosing high-risk plaques between groups A and B(P﹤0.01).Conclusions The multi-modal technology could reduce the radiation dose of MSCTCA scan in overweight and obese patients while clinical diagnostic needs were met.
作者
胡小露
黄培楷
张萌
刘金丰
陈妍黠
何涛
陈俊
肖梦强
HU Xiao-lu;HUANG Pei-kai;ZHANG Meng;LIU Jing-feng;CHEN Yan-xia;HE Tao;CHEN Jun;XIAO Meng-qiang(Department of Imaging,Zhuhai Hospital,Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai 519015,Guangdong Province,China)
出处
《中国CT和MRI杂志》
2022年第11期88-91,共4页
Chinese Journal of CT and MRI
基金
珠海市医学科研基金(ZH331020001PJL)。
关键词
肥胖
冠状动脉
多模态技术
CT
Obesity
Coronary Artery
Multimodal Technology
CT
