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双源计算机断层扫描冠状动脉造影中的辐射剂量估计

Radiation dose estimates in dual-source computed tomography coronary angiography.

作者信息

Stolzmann Paul, Scheffel Hans, Schertler Thomas, Frauenfelder Thomas, Leschka Sebastian, Husmann Lars, Flohr Thomas G, Marincek Borut, Kaufmann Philipp A, Alkadhi Hatem

机构信息

Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.

出版信息

Eur Radiol. 2008 Mar;18(3):592-9. doi: 10.1007/s00330-007-0786-8. Epub 2007 Oct 2.

Abstract

The purpose of this study was to quantify radiation dose parameters of dual-source CT coronary angiography. Eighty patients underwent contrast-enhanced, retrospectively ECG-gated dual-source CT coronary angiography with heart rate-adapted ECG pulsing using two algorithms: In 40 patients, the tube current was reduced to 20% (A(min1)) of the normal tube current (A(max)) outside the pulsing window; in 40 patients tube current was reduced to 4% (A(min2)) of A(max). Mean CTDI(vol) in the A(min1) group was 45.1 +/- 3.6 mGy; the mean CTDI(vol) in the A(min2) group was 39.1 +/- 3.2 mGy, with CTDI(vol) in the A(min2) group being significantly reduced when compared to the A(min1) group (P < 0.001). A significant negative correlation was found between CTDI(vol) and heart rate in group A(min1) (r = -0.82, P < 0.001), whereas no correlation was found between CTDI(vol) and heart rate in group A(min2) (r = -0.066). Using the conversion coefficient for the chest, dual-source CT coronary angiography resulted in an estimated mean effective dose of 8.8 mSv in the A(min1) group and 7.8 mSv in the A(min2). Radiation exposure of dual-source CT coronary angiography using an ECG-pulsing protocol reducing the tube current to 20% significantly decreases with increasing heart rates, despite using wider pulsing windows at higher heart rates. When using a protocol with reduced tube current of 4%, the radiation dose is significantly lower, irrespective of the heart rate.

摘要

本研究的目的是对双源CT冠状动脉造影的辐射剂量参数进行量化。80例患者接受了对比增强、回顾性心电图门控双源CT冠状动脉造影,采用两种算法进行心率适应性心电图脉冲扫描:40例患者在脉冲窗之外将管电流降低至正常管电流(A(max))的20%(A(min1));40例患者将管电流降低至A(max)的4%(A(min2))。A(min1)组的平均容积CT剂量指数(CTDI(vol))为45.1±3.6 mGy;A(min2)组的平均CTDI(vol)为39.1±3.2 mGy,与A(min1)组相比,A(min2)组的CTDI(vol)显著降低(P<0.001)。在A(min1)组中,CTDI(vol)与心率之间存在显著负相关(r = -0.82,P<0.001),而在A(min2)组中CTDI(vol)与心率之间未发现相关性(r = -0.066)。利用胸部的转换系数,双源CT冠状动脉造影在A(min1)组的估计平均有效剂量为8.8 mSv,在A(min2)组为7.8 mSv。使用心电图脉冲协议将管电流降低至20%的双源CT冠状动脉造影的辐射暴露随着心率增加而显著降低,尽管在较高心率时使用了更宽的脉冲窗。当使用管电流降低4%的协议时,无论心率如何,辐射剂量都显著更低。

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