Husmann L, Leschka S, Boehm T, Desbiolles L, Schepis T, Koepfli P, Gaemperli O, Marincek B, Kaufmann P, Alkadhi H
Universitätsspital Zürich, Institut für Diagnostische Radiologie, Departement für Medizinische Radiologie.
Rofo. 2006 Oct;178(10):1007-13. doi: 10.1055/s-2006-926871. Epub 2006 Aug 7.
To evaluate the influence of the body mass index (BMI) on coronary artery opacification in 64-slice CT.
Sixty-two patients retrospectively underwent ECG-gated 64-slice CT coronary angiography (tube potential 120 kV, tube current time product 650 mAs) after intravenous injection of 80 ml of iodinated contrast agent (320 mg/ml, 5 ml/s). Attenuation values (HU) were measured and contrast-to-noise ratios (CNR) were calculated in the right coronary artery (RCA) and left main artery (LMA). The CNR was defined as the difference between the mean attenuation in the vessel and the mean attenuation in the perivascular fat tissue divided by the image noise in the ascending aorta. The height and weight of the patients at the time of the CT scan were recorded and the BMI was calculated.
The mean BMI was 26.2 +/- 3.2 kg/m (2) (range 19.7 - 32.2 kg/m (2)), the mean attenuation in the LMA was 330 +/- 64 HU, and the mean attenuation in the RCA was 309 +/- 68 HU. The CNR in the LMA was 16.7 +/- 3.8, and the CNR in the RCA was 15.9 +/- 3.6. The image noise in the ascending aorta significantly correlated with the BMI (r = 0.36, p < 0.01). A weak negative correlation was found between the BMI and LMA attenuation (r = - 0.28, p < 0.05), whereas no significant correlation was found for the RCA (r = - 0.21, p = 0.12). A significant negative correlation was found between the BMI and the CNR in the RCA (r = - 0.41, p < 0.05) and the LMA (r = - 0.47, p < 0.001).
With constant scan parameters and a constant contrast medium amount, the CNR in both coronary arteries decreases while the BMI increases. This implies a modification of previously standardized and fixed examinations with respect to individually adapted protocols with variable parameters for CT coronary angiography.
评估体重指数(BMI)对64层CT冠状动脉显影的影响。
62例患者在静脉注射80ml碘化造影剂(320mg/ml,5ml/s)后,回顾性接受心电图门控64层CT冠状动脉造影(管电压120kV,管电流时间乘积650mAs)。测量右冠状动脉(RCA)和左主干动脉(LMA)的衰减值(HU),并计算对比噪声比(CNR)。CNR定义为血管内平均衰减与血管周围脂肪组织平均衰减之差除以升主动脉图像噪声。记录患者CT扫描时的身高和体重,并计算BMI。
平均BMI为26.2±3.2kg/m²(范围19.7 - 32.2kg/m²),LMA平均衰减为330±64HU,RCA平均衰减为309±68HU。LMA的CNR为16.7±3.8,RCA的CNR为15.9±3.6。升主动脉图像噪声与BMI显著相关(r = 0.36,p < 0.01)。BMI与LMA衰减之间存在弱负相关(r = - 0.28,p < 0.05),而RCA未发现显著相关性(r = - 0.21,p = 0.12)。BMI与RCA(r = - 0.41,p < 0.05)和LMA(r = - 0.47,p < 0.001)的CNR之间存在显著负相关。
在扫描参数和造影剂用量恒定的情况下,随着BMI增加,两支冠状动脉的CNR均降低。这意味着对于CT冠状动脉造影,在根据个体调整可变参数的方案方面,需要对先前标准化和固定的检查进行调整。