Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Spain.
Clin Radiol. 2012 Sep;67(9):833-9. doi: 10.1016/j.crad.2011.11.016. Epub 2012 Jun 8.
To determine the image quality and diagnostic performance of an optimized pulmonary computed tomography angiography (CTA) protocol in terms of radiation and contrast volume saving.
Seventy consecutive patients weighting ≤80 kg with clinical suspicion of pulmonary embolism (PE) were prospectively enrolled. Two pulmonary CTA protocols (group A: n = 35, 80 kV/60 ml; group B: n = 35, 100 kV/80 ml) were compared. The presence of PE, image quality parameters [contrast attenuation, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR)] and effective radiation dose (mSv) were assessed.
PE was found in 11 patients (five of group A, six of group B). The total mean attenuation of the pulmonary arteries was significantly higher in group A (362.4 ± 100.2 HU) than in group B (262.4 ± 134.3 HU), whereas the CNR and SNR did not differ statistically (14.8 ± 7.4 and 16.3 ± 7.5 for group A and 12.5 ± 8.6 and 13.8 ± 9.1 for group B, respectively). The estimated effective radiation dose was significantly lower in group A (1.1 ± 0.7 mSv) than in group B (2.7 ± 1.2 mSv).
In individuals weighting ≤80 kg, the evaluated pulmonary CTA protocol allows similar image quality to be achieved as compared with the conventional pulmonary CTA protocol while reducing radiation exposure by 60% and contrast media volume by 25%.
确定一种优化的肺部 CT 血管造影(CTA)方案在节省辐射和对比剂用量方面的图像质量和诊断性能。
前瞻性纳入 70 例体重≤80kg、疑似肺栓塞(PE)的连续患者。比较两种肺部 CTA 方案(A 组:n=35,80kV/60ml;B 组:n=35,100kV/80ml)。评估 PE 的存在、图像质量参数[对比剂衰减、对比噪声比(CNR)和信噪比(SNR)]和有效辐射剂量(mSv)。
11 例患者(A 组 5 例,B 组 6 例)发现 PE。A 组肺动脉总平均衰减值(362.4±100.2HU)明显高于 B 组(262.4±134.3HU),而 CNR 和 SNR 无统计学差异(A 组分别为 14.8±7.4 和 16.3±7.5,B 组分别为 12.5±8.6 和 13.8±9.1)。A 组的估计有效辐射剂量(1.1±0.7mSv)明显低于 B 组(2.7±1.2mSv)。
在体重≤80kg 的个体中,与常规肺部 CTA 方案相比,评估的肺部 CTA 方案可实现相似的图像质量,同时降低 60%的辐射暴露和 25%的对比剂用量。