Luo Song, Zhang Long Jiang, Meinel Felix G, Zhou Chang Sheng, Qi Li, McQuiston Andrew D, Schoepf U Joseph, Lu Guang Ming
Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China.
Eur Radiol. 2014 Jul;24(7):1677-85. doi: 10.1007/s00330-014-3184-z. Epub 2014 May 4.
To evaluate the image quality, radiation dose and diagnostic accuracy of low kVp and low contrast material volume cerebral CT angiography (CTA) in intracranial aneurysm detection.
One hundred twenty patients were randomly divided into three groups (n = 40 for each): Group A, 70 ml iodinated contrast agent/120 kVp; group B, 30 ml/100 kVp; group C, 30 ml/80 kVp. The CT numbers, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured in the internal carotid artery (ICA) and middle cerebral artery (MCA). Subjective image quality was evaluated. For patients undergoing DSA, diagnostic accuracy of CTA was calculated with DSA as reference standard and compared.
CT numbers of ICA and MCA were higher in groups B and C than in group A (P < 0.01). SNR and CNR in groups A and B were higher than in group C (both P < 0.05). There was no difference in subjective image quality among the three groups (P = 0.939). Diagnostic accuracy for aneurysm detection among these groups had no statistical difference (P = 1.00). Compared with group A, the radiation dose of groups B and C was decreased by 45% and 74%.
Cerebral CTA at 100 or 80 kVp using 30 ml contrast agent can obtain diagnostic image quality with a low radiation dose while maintaining the same diagnostic accuracy for aneurysm detection.
• Cerebral CTA is feasible using 100/80 kVp and 30 ml contrast agent. • This approach obtains diagnostic image quality with 45-74% radiation dose reduction. • Diagnostic accuracy for intracranial aneurysm detection seems not to be compromised.
评估低千伏（kVp）和低对比剂用量的脑CT血管造影（CTA）在颅内动脉瘤检测中的图像质量、辐射剂量及诊断准确性。
120例患者随机分为三组（每组n = 40）：A组，70 ml碘化对比剂/120 kVp；B组，30 ml/100 kVp；C组，30 ml/80 kVp。测量颈内动脉（ICA）和大脑中动脉（MCA）的CT值、噪声、信噪比（SNR）和对比噪声比（CNR）。评估主观图像质量。对于接受数字减影血管造影（DSA）的患者，以DSA为参考标准计算并比较CTA的诊断准确性。
B组和C组ICA和MCA的CT值高于A组（P < 0.01）。A组和B组的SNR和CNR高于C组（均P < 0.05）。三组主观图像质量无差异（P = 0.939）。这些组间动脉瘤检测的诊断准确性无统计学差异（P = 1.00）。与A组相比，B组和C组的辐射剂量分别降低了45%和74%。
使用30 ml对比剂的100或80 kVp脑CTA在保持动脉瘤检测诊断准确性的同时，可获得低辐射剂量的诊断图像质量。
• 使用100/80 kVp和30 ml对比剂进行脑CTA是可行的。• 这种方法可获得诊断图像质量，辐射剂量降低45 - 74%。•颅内动脉瘤检测的诊断准确性似乎未受影响。
