低辐射剂量低浓度造影剂螺旋CT在肺动脉CTA扫描中的应用价值

摘要

目的:探讨低辐射剂量低浓度造影剂螺旋CT在肺动脉CTA扫描中的应用价值.方法:选取2015年5月至2016年5月在本院接受肺动脉CTA扫描的患者56例为研究对象,随机分为常规扫描组和"双低"扫描组,每组各28例.采用东芝Aquilion ONE 320排螺旋CT进行扫描,常规扫描组管电压120KV,造影剂欧乃派克350mg/mL,"双低"扫描组管电压100KV,造影剂威视派克270mg/mL.图像分析由同机Vitrea FX工作站完成,比较两组患者肺动脉各段CT值,噪声值(SD),图像信噪比(SNR),比噪声比(CNR),图像质量评分,CT容积剂量指数(CTDIvol),剂量长度乘积(DLP),有效辐射剂量(ED),以及碘摄入量.结果:两组患者肺动脉主干、肺动脉叶、肺段动脉,以及肺亚段动脉CT值比较差异无统计学意义(P>0.05).常规扫描组和"双低"扫描组的SD[(7.7±2.1)vs(8.3±2.4)]、SNR[(23.9±7.3)vs(25.1±7.8)]、CNR[(24.9±6.6)vs(27.1±7.2)]和图像质量评分[(4.1±0.8)vs(3.8±0.8)],均无统计学差异(P>0.05)."双低"扫描组的CTDIvol[(6.1±0.4)vs(8.4±0.6)mGy]、DLP[(293.4±21.7)vs(391.5±33.2)mGy.cm]、ED[(4.3±0.4)vs(5.7±0.6)mSv/mGy.cm],以及碘摄入量[(6.2±0.9)vs(8.3±1.1)g],均低于常规剂量组,差异具有统计学意义(P<0.001).结论:低辐射剂量低浓度造影剂扫描可以获得较好的图像质量,以满足临床诊断需要,而且与常规扫描比较,能显著降低辐射量和碘摄入量.%Objective:To investigate the application value of spiral CT pulmonary angiography with low radiation dose and low dose contrast agent. Methods:Fifty-six patients received spiral CT pulmonary angiog-raphy in our hospital from May 2015 to May 2016 were selected as the research objects. All of the patients were randomly assigned into routine scan group (n=28) and double low dose scan group (n=28). Toshiba ONE Aquilion 320 slice spiral CT was used to check, the routine scan group ( 120kv, Omnipaque 350mgI/ml), the double low dose scan group (100kV, Visipaque 270mgI/ml), the other parameters were the same. The following parameters of two groups were compared:the CT values of each segment of the pulmonary arter-y, the values of noise, the signal-to-noise ratio ( SNR) and contrast-to-noise ratio ( CNR) , the quality of the pictures, the CT dose index ( CTDIvol) , dose length product ( DLP ) , effective radiation dose ( ED) and iodine intake. Results:The CT values of each segment of the pulmonary artery of two groups had no significant difference (P>0.05). The values of SD [(7.7±2.1) vs (8.3±2.4)], SNR [ (23.9±7.3) vs (25.1±7.8)], CNR[(24.9±6.6) vs (27.1±7.2)], and the scores of picture quality [(4.1±0.8) vs (3.8±0.8)] of two groups had no difference (P<0.001). The CTDIvol [(6.1±0.4) vs (8.4±0.6)mGy], DLP [(293.4±21.7) vs (391.5±33.2) mGy.cm], ED [(4.3±0.4) vs (5.7±0.6)mSv/mGy.cm] and Iodine intake [(6.2±0.9) vs (8.3±1.1)g] of the double low dose scan group were lower than the routine scan group (P<0.001). Conclu-sion:Spiral CT with low radiation dose and low dose contrast agent can get good picture quality and meet the needs of clinical diagnosis, but also significantly reduce the radiation and iodine intake.