Influence of reducing contrast agent dose on image quality in patients with 256-slice CT coronary angiography
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摘要:目的 探讨降低对比剂剂量对256层螺旋CT冠状动脉造影检查成像质量和辐射剂量的影响。方法 将120例患者随机分为观察组和对照组，每组60例。采用回顾性心电门控冠状动脉成像技术，对照组按照1 mL/kg标准注入对比剂，观察组参照对照组标准减少10 mL对比剂剂量。测量2组左主动脉干（AO）、左前降支近远段（LADp、LADd）、右冠状动脉近远段（RCAp、RCAd）、回旋支近远段（LCXp、LCXd）平均CT值。评估冠状动脉节段图像质量，分析左心室、室间隔、右心室显示情况，计算有效辐射剂量。结果 2组均顺利完成CT检查，2组LCXp、LCXd、RCAp、RCAd、LADp、LADd的平均CT值差异无统计学意义（P>0.05）。2组冠状动脉节段优良率差异无统计学意义（P>0.05）。2组图像质量评分差异无统计学意义（P>0.05）。观察组左心室壁、室间隔、上腔静脉和右心室伪影情况等显示良好的比率高于对照组，差异有统计学意义（P < 0.05）。观察组对比剂用量低于对照组，差异有统计学意义（P < 0.05）。结论 在256层CT冠状动脉造影检查中，降低对比剂剂量可明显降低辐射剂量，同时图像质量也能满足诊断要求。Abstract:Objective To investigate the influence of reducing contrast agent dose on the image quality and radiation dose in patients with 256-slice CT coronary angiography.Methods Totally 120 patients were randomly divided into experimental group and control group, with 60 cases in each group. A retrospective electrocardiography-gated coronary artery imaging technique was applied. The control group was injected with contrast agent according to the standard of 1 mL/kg, and the observation group reduced the dose of 10 mL contrast agent according to the standard of the control group. The mean CT values of left aortic stem (AO), the left anterior descending branch of proximal and distal parts (LADp, LADd), right coronary artery proximal and distal parts (RCAp, RCAd), LCX proximal and distal parts (LCXp, LCXd) were measured. The image quality of coronary artery segments was evaluated, the display of left ventricle, interventricular septum and right ventricle was analyzed, and the effective radiation dose was calculated.Results All the patients successfully completed their CT examinations. There were no significant differences in the mean CT values of LCXp, LCXd, RCAp, RCAd, LADp and LADd between the two groups (P>0.05). There was no significant difference in the excellent rate of coronary segment between two groups (P>0.05). There was no significant difference in image quality score between the two groups (P>0.05). The observation group showed better ratios of cases with good artifact display in left ventricular wall, interventricular septum, superior vena cava and right ventricular artifacts than the control group (P < 0.05). The dosage of contrast agent in the observation group was significantly lower than that of the control group (P < 0.05).Conclusion In 256-slice CT coronary angiography, reducing the dose of contrast agent can significantly reduce the radiation dose, and the image quality can also meet the diagnostic requirements.
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Keywords:
- contrast agent dose /
- coronary angiography /
- image quality /
- radiation dose
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表 1 2组一般资料比较(x±s)
组别 男 女 年龄/岁 体质量指数/(kg/m2) 心率/(次/min) 扫描范围/mm 观察组(n=60) 31 29 56.97±6.07 21.97±5.45 73.11±5.32 125.33±11.43 对照组(n=60) 32 28 57.55±6.61 21.52±5.94 72.54±4.91 124.72±10.57 
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表 2 2组冠状动脉各分支血管CT值分析(x±s)
HU 组别 AO LCXp LCXd RCAp RCAd LADp LADd 观察组(n=60) 391.32±75.71 382.44±67.63 384.20±56.25 408.91±47.15 409.82±39.41 392.54±54.06 393.61±52.22 对照组(n=60) 387.63±74.92 389.23±65.75 387.52±52.62 406.71±46.31 407.43±37.72 390.63±52.11 392.58±51.69 AO: 升主动脉; LCXp: 回旋支近段; LCXd: 回旋支远段; RCAp: 右冠状动脉近段; RCAd: 右冠状动脉远段;
LADp: 左冠状动脉前降支近段; LADd: 左冠状动脉前降支远段。
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表 3 2组冠状动脉节段图像质量评价[n(%)]
组别 图像质量评分 可评价节段 优良节段 1分 2分 3分 4分 5分 观察组(n=762) 3 6 47 154 552 753(98.82) 706(92.65) 对照组(n=757) 4 7 45 150 551 746(98.55) 701(92.60) n为节段计数。
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表 4 2组左心室、室间隔显示情况比较[n(%)]
组别 左心室壁 室间隔 良好 一般 差 清晰 尚可 差 观察组(n=60) 41(68.33)* 19(31.67)* 0 34(56.67)* 23(38.33)* 3(5.00) 对照组(n=60) 27(45.00) 30(50.00) 3(5.00) 21(35.00) 38(63.33) 1(1.67) 与对照组比较, *P < 0.05。
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表 5 2组上腔静脉及右心室伪影显示情况[n(%)]
组别 0级 1级 2级 观察组(n=60) 43(71.67)* 17(28.33)* 0 对照组(n=60) 31(51.67) 29(48.33) 0 与对照组比较, *P < 0.05。
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