基于团注试验参数的冠状动脉CT血管造影个体化调整管电流选择及对比剂注射方案：一项可行性研究

Individually adapted tube current selection and contrast medium injection protocol of coronary CT angiography based on test bolus parameters: a feasibility study.

作者信息

Zhu Xiaomei, Shi Zhaofei, Zhu Yinsu, Liu Wangyan, Yang Guanyu, Yu Tongfu, Tang Lijun, Xu Yi

机构信息

Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China.

Laboratory of Image Science & Technology, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu, PR China.

出版信息

Acta Radiol. 2015 Jun;56(6):666-72. doi: 10.1177/0284185114536156. Epub 2014 Jun 17.

DOI:10.1177/0284185114536156

PMID:24938658

Abstract

BACKGROUND

Test bolus is mostly used to determine the starting point of a full cardiac scanning with respect to injection of a larger bolus of contrast material. So far there are limited data demonstrating the feasibility of using information obtained from a test bolus to adjust contrast delivery protocols and tube current individually during coronary computed tomography angiography (CCTA).

PURPOSE

To evaluate the feasibility of individually adapted tube current selection and contrast injection protocols of CCTA based on test bolus parameters.

MATERIAL AND METHODS

Test bolus followed by CCTA was performed in 93 patients at 100 kV and in 81 patients at 120 kV, respectively. Simulated attenuation of the descending aorta (SimDA) of CCTA was calculated at a fixed contrast injection rate of 4 mL/s. Univariate and multivariate comparisons were performed to identify associations of SimDA and image noise of CCTA (NoiseCCTA) with test bolus information and patient-related factors including body weight (BW), body mass index (BMI), and body surface area (BSA).

RESULTS

Compared with BW, BMI, and BSA, SimDA was more closely related to the peak time of left ventricle and peak enhancement of right ventricle obtained from test bolus (r = 0.495 and r = 0.642 for 100 and 120 kV protocol, respectively). Similarly, NoiseTB was much more closely related to NoiseCCTA (r = 0.740 and r = 0.630 for 100 and 120 kV protocol, respectively) when compared with BW, BMI, and BSA.

CONCLUSION

It is feasible to individually adapt tube current and contrast injection protocol of CCTA based on the information of test bolus.

摘要

背景

测试团注主要用于确定在注射较大剂量造影剂时进行完整心脏扫描的起始点。到目前为止，仅有有限的数据表明在冠状动脉计算机断层扫描血管造影（CCTA）期间利用从测试团注获得的信息来分别调整造影剂输送方案和管电流的可行性。

目的

评估基于测试团注参数分别调整CCTA的管电流选择和造影剂注射方案的可行性。

材料与方法

分别对93例患者在100 kV下以及81例患者在120 kV下先进行测试团注，随后进行CCTA。以4 mL/s的固定造影剂注射速率计算CCTA降主动脉的模拟衰减（SimDA）。进行单因素和多因素比较，以确定SimDA和CCTA图像噪声（NoiseCCTA）与测试团注信息以及包括体重（BW）、体重指数（BMI）和体表面积（BSA）在内的患者相关因素之间的关联。

结果

与BW、BMI和BSA相比，SimDA与从测试团注获得的左心室峰值时间和右心室峰值强化更密切相关（100 kV方案时r = 0.495，120 kV方案时r = 0.642）。同样，与BW、BMI和BSA相比，NoiseTB与NoiseCCTA的相关性更强（100 kV方案时r = 0.740，120 kV方案时r = 0.630）。