低碘流率多层螺旋CT冠状动脉造影对斑块诊断价值的研究

摘要

Objective To investigate the value of multi -slice spiral CT( MSCT)coronary angiography with low iodine flow rate in plaque diagnosis. Methods Enrolled 30 patients with coronary heart diseases who undertook MSCT coronary angiography with low iodine flow rate in Shenzhen 4th People's Hospital from June 2013 to December 2014 and assigned them into low iodine flow group. Also enrolled another 30 patients with coronary heart diseases who undertook MSCT coronary angiography with normal iodine flow rate in the same period and assigned them into control group. With the same scanning condition and the same total amount of contrast medium,the two groups were examined with a iodine flow rate of 1 480 mgI/s and 1 850 mgI/s respectively(injection speeds were 4 ml/s and 5 ml/s). Workstation software was used to process images. The imaging quality, plaque indexes, contrast medium concentration and injection time were compared between the two groups. Results The two groups were not significantly different ( P >0. 05 ) in signal - to - noise ratio ( SNR ), carrier - to - noise ratio ( CNR ), imaging quality, imaging sharpness, plaque area ( PA ), plaque burden ( PB ), plaque eccentricity index and stenosis degree.Thetotalamountofcontrastmediumwas(68.5±4.9)mlforcontrolgroupand(56.8±6.3)mlforlowiodineflow group,with significant difference between the two groups(t=8. 067,P<0. 001). The injection time was(14. 4 ±1. 5)s for control group and(14.0 ± 0.9)s for low iodine flow group,with no significant difference between them(t =1.282,P=0. 205). Conclusion MSCT coronary angiography with low iodine flow rate could ensure the imaging quality required by diagnosis,reduce the usage of contrast medium,and reduce adverse reactions like contrast-induced nephropathy. It is valuable in clinical application.%目的：探讨低碘流率多层螺旋CT（ MSCT）冠状动脉造影对斑块诊断的价值。方法收集2013年6月—2014年12月深圳市第四（福田）人民医院行低碘流率MSCT冠状动脉造影的冠心病患者30例为低碘流率组，另选择同时期行正常碘流率MSCT冠状动脉造影的冠心病患者30例为对照组，在相同扫描条件及对比剂浓度下，分别用1480 mgI/s及1850 mgI/s碘流率（注射流率分别为4 ml/s及5 ml/s）进行检查，利用工作站软件进行后处理图像，比较两组图像质量及斑块指标、对比剂总量、注射时间。结果对照组与低碘流率组信号-噪音比（ SNR）、对比噪音比（ CNR）、图像质量、图像锐利程度、斑块面积（ PA）、斑块负荷（ PB）、斑块偏心指数、狭窄程度（ SD）比较，差异均无统计学意义（P>0.05）。对照组对比剂总量为（68.5±4.9）ml，低碘流率组对比剂总量为（56.8±6.3）ml，两组比较差异有统计学意义（t=8.067，P<0.001）。对照组注射时间为（14.4±1.5）s，低碘流率组注射时间为（14.0±0.9） s，两组比较差异无统计学意义（ t=1.282，P=0.205）。结论使用低碘流率进行MSCT冠状动脉造影，不仅可以达到诊断要求的图像质量，还可以减少对比剂使用，减少对比剂肾病等不良反应的发生，具有一定的临床应用价值。