Department of Radiology, Lady Davis Carmel Medical Center, Haifa, Israel.
Int J Cardiovasc Imaging. 2012 Mar;28(3):633-9. doi: 10.1007/s10554-011-9848-8. Epub 2011 Mar 19.
To evaluate, objectively and subjectively, the feasibility of 256-row computed tomography coronary angiography (CTCA) in obese patients. 256-row CTCA was performed in 68 symptomatic patients (age 61 ± 10 years, 37 females), 39 obese (body mass index-BMI > 30 kg/m(2)) and 29 non-obese. Retrospective analysis was performed by two observers who assessed the image quality of each coronary segment using a 4-point subjective scale (1 excellent to 4 non-diagnostic), and another blinded observer measured objective image parameters. BMI in the obese group was 35 ± 5 (32-65) Kg/m(2), and 24 ± 3 (16-29) Kg/m(2) in the non-obese (P = 0.004). Average subjective image quality was similar in obese (1.41 ± 0.40) and non-obese (1.34 ± 0.40) patients, P = 0.17. Proportion of coronary artery segments with non-diagnostic image quality was low in both groups (0.7% in obese and 0.2% in non-obese, P = 0.31). Signal to noise and contrast to noise ratios were not significantly lower in obese than in non-obese patients (9.4 ± 3 vs. 12 ± 2.5, P = 0.16 and 11.1 ± 3.8 vs. 13.7 ± 2.9, P = 0.07 respectively). However, dose length product (1167 ± 567 vs. 827 ± 375 mGy × cm, P = 0.014) and image noise (44 ± 13 vs. 35 ± 5 HU, P < 0.001) were higher in the obese patient group. Image quality was preserved in obese patients undergoing 256-row CTCA at the cost of increased radiation exposure and image noise.
评估 256 层 CT 冠状动脉成像（CTCA）在肥胖患者中应用的可行性，需客观和主观地评估。68 例有症状患者（年龄 61±10 岁，女性 37 例）进行了 256 层 CTCA 检查，其中 39 例为肥胖患者（体重指数-BMI＞30kg/m²），29 例为非肥胖患者。两名观察者进行回顾性分析，采用 4 分主观评分（1 分为极好，4 分为无法诊断）评估每段冠状动脉的图像质量，另一名观察者进行盲法测量客观图像参数。肥胖组的 BMI 为 35±5（32-65）kg/m²，非肥胖组为 24±3（16-29）kg/m²（P=0.004）。肥胖患者（1.41±0.40）与非肥胖患者（1.34±0.40）的主观图像质量评分相似（P=0.17）。两组患者无法诊断的冠状动脉节段比例均较低（肥胖组为 0.7%，非肥胖组为 0.2%，P=0.31）。肥胖患者的信噪比和对比噪声比与非肥胖患者相比差异无统计学意义（分别为 9.4±3 与 12±2.5，P=0.16 和 11.1±3.8 与 13.7±2.9，P=0.07）。然而，肥胖患者的剂量长度乘积（1167±567 与 827±375 mGy×cm，P=0.014）和图像噪声（44±13 与 35±5 HU，P＜0.001）更高。肥胖患者的 256 层 CTCA 图像质量保持不变，但辐射暴露和图像噪声增加。
