在腹部脂肪患者中使用70kV双低剂量冠状动脉成像技术的可行性研究,使用双源CTCT
Lei Chen1, Shang Ge1, Yuan Chen1
1Department of Radiology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian 223300, China.
African health sciences
|February 15, 2024
概括
低管电压 (70 KV) 和冠状动脉CTA中的对比剂度对高BMI患者有效,显著降低了辐射剂量. 然而,对于超高的BMI患者来说,70 KV对于诊断图像质量是不够的.
科学领域:
- 放射学 放射学是一门学科.
- 医疗成像医学成像
- 心血管成像 - 心血管成像
背景情况:
- 冠状动脉计算机断层扫描血管造影 (CTA) 对于诊断冠状动脉疾病至关重要.
- 由于衰减增加,肥胖患者在CTA中存在挑战,通常需要更高的辐射剂量和对比度.
- 为肥胖患者优化CTA协议对于平衡图像质量和辐射安全至关重要.
研究的目的:
- 评估降低管电压 (70 KV) 和对比剂度在冠状动脉CTA中的高BMI和超高BMI患者的疗效.
- 为了比较图像质量,有效辐射剂量 (ED) 和低剂量协议与常规协议之间的诊断性能.
主要方法:
- 一项随机研究涉及120名患者 (60个高BMI,60个超高BMI),分为低剂量 (70 KV,270 mgI/ml) 和常规 (120 KV,370 mgI/ml) 组.
- 图像质量通过使用优点数 (FOM),信号噪声比 (SNR),对比噪声比 (CNR) 和主观分数来评估.
- 为所有组计算有效辐射剂量 (ED).
主要成果:
- 在高BMI患者中,低剂量组显示ED显著降低 (1.103±0.101 mSv与4.663±0.412 mSv),图像质量 (FOM,SNR,CNR) 和主观评分相似.
- 对于体重指数超高的患者,低剂量组 (70 KV) 的图像质量 (平均CT值,SNR,CNR) 和主观得分明显较低,14名患者的图像是非诊断的.
- 低剂量方案使用的总量显著减少,注射率也较低.
结论:
- 将管电压降低到70 KV,并降低对比度,对于高BMI (26-28 kg/m2) 患者的冠状动脉CTA是可行的和有效的.
- 对于超高BMI患者 (>28 kg/m2),70 KV协议不足以满足日常诊断要求.
- 优化的低剂量方案可以减少特定患者群体的辐射暴露和对比介质.
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