在冠状动脉计算机断层扫描中评估基于管电压的对比介质适应,使用个性化的三相注射协议进行血管扫描:一个匹配的病例对照研究
Chiara Gnasso1, Milan Vecsey-Nagy2, U Joseph Schoepf3
1Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, South Carolina 29425, USA; Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy.
自动管电压选择 (ATVS) 适应的对比介质 (CM) 协议在冠状动脉CT血管造影 (CCTA) 中显著减少CM体积,而不会影响图像质量或辐射剂量. 这一创新优化了疑似冠状动脉疾病 (CAD) 的CCTA.
科学领域:
- 放射学 放射学是一门学科.
- 心血管成像 - 心血管成像
- 医学物理 医学物理
背景情况:
- 冠状动脉CT血管图 (CCTA) 是疑似冠状动脉疾病 (CAD) 的一线诊断工具.
- 越来越多的CCTA利用需要策略来最大限度地减少辐射和对比介质 (CM) 暴露.
- 优化CM注射协议对于平衡诊断疗效和患者安全至关重要.
研究的目的:
- 为了评估自动管电压选择 (ATVS) 适应的CM注入协议用于CCTA.
- 为了比较其性能与标准的三相协议关于图像质量,辐射剂量和CM管理.
- 评估降低CM体积的可行性,同时保持诊断图像质量.
主要方法:
- 预期招募120名接受CCTA的患者,使用适应ATVS的三相CM协议 (70-130kV).
- 与使用相同CT系统上的标准三相CM协议进行120次追溯对照进行比较.
- 评估辐射剂量,主观图像质量,对比度与噪声比率 (CNR) 和信号与噪声比率 (SNR).
主要成果:
- 与对照组 (51.3 mL) 相比,ATVS组 (46.0 mL) 的CM体积显著减少 (p < 0.001).
- 辐射剂量没有显著差异 (6.13 mSv对比5.97 mSv,p = 0.81).
- 组之间可以比较主观图像质量 (中位数为4比4,p=0.40) 和客观图像质量 (CNR,SNR).
结论:
- 适应ATVS的CM注射协议使诊断质量的CCTA能够减少CM体积.
- 该协议保持了与标准协议相比的辐射暴露和图像质量.
- 适应ATVS的协议代表了优化CCTA程序的宝贵进步.
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