冠状动脉搭桥术中的冠状动脉计算机断层血管造影：低浓度碘克沙醇270与碘海醇350的比较。
Coronary computed tomographic angiography in coronary artery bypass grafts: comparison between low-concentration Iodixanol 270 and Iohexol 350.
作者信息
Wang Hui, Xu Lei, Zhang Nan, Fan Zhanming, Zhang Zhaoqi, Sun Zhonghua
机构信息
From the *Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; and †Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, Perth, Western Australia, Australia.
出版信息
J Comput Assist Tomogr. 2015 Jan-Feb;39(1):112-8. doi: 10.1097/RCT.0000000000000162.
OBJECTIVE
The aim of this study was to evaluate the feasibility of low-concentration iso-osmolar Iodixanol 270 compared with Iohexol 350 in patients with coronary artery bypass grafts (CABGs) undergoing coronary computed tomographic angiography (CCTA).
METHODS
A total of 80 consecutive patients undergoing CABG follow-up with the use of CCTA were prospectively enrolled, with 40 patients assigned to Iodixanol 270 and 40 patients assigned to Iohexol 350. In both groups, the contrast medium was injected at an injection rate of 4.5 mL/s in the patients with a body mass index of greater than 24 kg/m2 and 3.5 mL/s in the patients with a body mass index of 24 kg/m2 or lower. The contrast volume was determined by the flow rate and scan time. Image quality score and visualization of bypass grafts were evaluated. Subjective assessment of image quality for each coronary artery segment was determined using a 4-point grading scale by 2 reviewers, whereas objective evaluation of image quality was conducted by measuring the mean CT attenuation values (hounsfield unit [HU]) in terms of SD, contrast-noise ratio, and signal-noise ratio in the ascending aorta.
RESULTS
The mean (SD) contrast volume for the Iodixanol 270 and Iohexol 350 groups was 66.28 (12.00) and 64.98 (8.12) mL, respectively, with no significant difference (P = 0.57). The mean (SD) CT attenuation value in the Iodixanol 270 group was 414.72 (101.47), which was lower than in the Iohexol 350 group, which was 478.85 (108.73) (P = 0.01). The subjective image quality for the Iodixanol 270 group was superior to that for the Iohexol 350 group in the arterial graft vessels (P = 0.027), whereas there was no significant difference between the 2 groups in the venous graft vessels (P = 0.377). There was no significant difference in terms of SD of the ascending aorta, signal-noise ratio, and contrast-noise ratio between the 2 groups.
CONCLUSIONS
Low-concentration iso-osmolar Iodixanol 270 provides image quality comparable with that of Iohexol 350, allowing diagnostic CCTA follow-up of patients with CABGs.
目的
本研究旨在评估低浓度等渗碘克沙醇270与碘海醇350相比，在接受冠状动脉计算机断层血管造影（CCTA）的冠状动脉旁路移植术（CABG）患者中的可行性。
方法
前瞻性纳入80例连续接受CABG随访并行CCTA检查的患者，40例患者分配至碘克沙醇270组，40例患者分配至碘海醇350组。两组中，体重指数大于24kg/m²的患者造影剂注射速率为4.5mL/s，体重指数为24kg/m²或更低的患者注射速率为3.5mL/s。造影剂用量由流速和扫描时间确定。评估图像质量评分和旁路移植血管的显影情况。由2名阅片者使用4分制分级量表对每个冠状动脉节段的图像质量进行主观评估，而图像质量的客观评估则通过测量升主动脉的平均CT衰减值（亨氏单位[HU]）、标准差、对比噪声比和信噪比来进行。
结果
碘克沙醇270组和碘海醇350组的平均（标准差）造影剂用量分别为66.28（12.00）mL和64.98（8.12）mL，差异无统计学意义（P = 0.57）。碘克沙醇270组的平均（标准差）CT衰减值为414.72（101.47），低于碘海醇350组的478.85（108.73）（P = 0.01）。碘克沙醇270组在动脉移植血管中的主观图像质量优于碘海醇350组（P = 0.027），而两组在静脉移植血管中的主观图像质量差异无统计学意义（P = 0.377）。两组在升主动脉的标准差、信噪比和对比噪声比方面差异无统计学意义。
结论
低浓度等渗碘克沙醇270提供的图像质量与碘海醇350相当，可用于CABG患者的诊断性CCTA随访。
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