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低对比剂剂量方案,涉及对肾功能不全患者的高血供肝细胞癌采用100 kVp管电压。

Low contrast dose protocol involving a 100 kVp tube voltage for hypervascular hepatocellular carcinoma in patients with renal dysfunction.

作者信息

Nakaura Takeshi, Nagayama Yasunori, Kidoh Masafumi, Nakamura Shinichi, Namimoto Tomohiro, Awai Kazuo, Harada Kazunori, Yamashita Yasuyuki

机构信息

Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto, 863-0046, Japan.

Department of Diagnostic Radiology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.

出版信息

Jpn J Radiol. 2015 Sep;33(9):566-76. doi: 10.1007/s11604-015-0457-7. Epub 2015 Jul 11.

Abstract

PURPOSE

To evaluate the feasibility of a 20 % reduced contrast dose hepatic arterial phase (HAP) CT for hypervascular hepatocellular carcinoma (HCC) with 100 kVp.

MATERIALS AND METHODS

The study included 97 patients with hypervascular HCC who underwent dynamic CT, including HAP scanning. The 54 patients had an estimated glomerular filtration rate (eGFR) of ≥60 were scanned with our conventional 120 kVp protocol. The other 43 patients (eGFR < 60) underwent scans using a tube voltage of 100 kVp and a 20 % reduced contrast dose. We compared the estimated effective dose, image noise, tumor-liver contrast (TLC), and contrast-to-noise ratio (CNR) in the hepatic arterial phase between the two groups using the Student's t test.

RESULTS

Estimated effective dose and image noise were not significantly different between these groups (p = 0.67 and p = 0.20, respectively). The TLC and CNR were significantly higher for the 100 kVp protocol than for the 120 kVp protocol (52.2 HU ± 17.4 vs 40.8 HU ± 18.6, p < 0.01 and 6.8 ± 2.6 vs 5.5 ± 2.4, p = 0.01, respectively).

CONCLUSION

For hepatic arterial phase CT of hypervascular HCC, 100 kVp scan allows a 20 % reduction in the contrast dose without reduction in image quality compared with a standard 120 kVp CT protocol.

摘要

目的

评估采用100 kVp管电压、降低20%对比剂剂量的肝脏动脉期(HAP)CT用于诊断富血供肝细胞癌(HCC)的可行性。

材料与方法

本研究纳入97例接受动态CT检查(包括HAP扫描)的富血供HCC患者。54例估计肾小球滤过率(eGFR)≥60的患者采用我们常规的120 kVp扫描方案。另外43例患者(eGFR < 60)采用100 kVp管电压及降低20%对比剂剂量进行扫描。我们采用Student's t检验比较两组肝脏动脉期的估计有效剂量、图像噪声、肿瘤-肝脏对比度(TLC)及对比噪声比(CNR)。

结果

两组间估计有效剂量和图像噪声无显著差异(分别为p = 0.67和p = 0.20)。100 kVp扫描方案的TLC和CNR显著高于120 kVp扫描方案(分别为52.2 HU ± 17.4 vs 40.8 HU ± 18.6,p < 0.01;6.8 ± 2.6 vs 5.5 ± 2.4,p = 0.01)。

结论

对于富血供HCC的肝脏动脉期CT检查,与标准的120 kVp CT扫描方案相比,100 kVp扫描可在不降低图像质量的情况下使对比剂剂量降低20%。

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