Hausleiter Jörg, Meyer Tanja
Deutsches Herzzentrum München, Klinik an der Technischen Universität München, Munich, Germany.
J Cardiovasc Comput Tomogr. 2008 Sep-Oct;2(5):325-7. doi: 10.1016/j.jcct.2008.08.012. Epub 2008 Aug 22.
The use of cardiac computed tomography (CT) to noninvasively visualize the coronary arteries has rapidly increased during the last few years but thereby also has raised concerns about the amount of radiation exposure and its potentially associated hazards. In this article, we summarize several strategies and new scanning techniques for dose reduction in cardiac CT, including the following: 1) Coronary CT angiography should not be performed in patients with extensive coronary calcifications because the probability to rule out obstructive coronary artery disease diminishes with increasing coronary artery calcium scores; 2) The scan length in CT angiography should be individually adjusted to the minimum needed length; 3) electrocardiogram-correlated modulation of the tube current should be applied in all patients with stable sinus rhythm; 4) The tube voltage should be reduced to 100 kV in non-obese patients (patient weight <85-90 kg); and 5) A sequential scan mode with prospective electrocardiogram triggering should be considered in patients with a stable heart rate <or=63 beats/min. With the appropriate use of these strategies for dose reduction, the diagnostic image quality is maintained. Therefore, these strategies should be rigidly applied in daily practice to obtain diagnostic images with the lowest possible radiation dose in every patient.
在过去几年中，心脏计算机断层扫描（CT）用于无创可视化冠状动脉的应用迅速增加，但这也引发了对辐射暴露量及其潜在相关危害的担忧。在本文中，我们总结了几种用于降低心脏CT辐射剂量的策略和新的扫描技术，包括以下几点：1）对于冠状动脉广泛钙化的患者，不应进行冠状动脉CT血管造影，因为随着冠状动脉钙化评分的增加，排除阻塞性冠状动脉疾病的可能性会降低；2）CT血管造影中的扫描长度应根据个体情况调整至所需的最短长度；3）对于所有窦性心律稳定的患者，应采用与心电图相关的管电流调制；4）对于非肥胖患者（患者体重<85 - 90 kg），管电压应降至100 kV；5）对于心率稳定<或 = 63次/分钟的患者，应考虑采用前瞻性心电图触发的序列扫描模式。通过适当使用这些降低剂量的策略，可以保持诊断图像质量。因此，在日常实践中应严格应用这些策略，以便为每位患者获得辐射剂量尽可能低的诊断图像。
