Wu Qiyong, Wang Yong, Kai Huihua, Wang Tao, Tang Xiaoqiang, Wang Xiaoqin, Pan Changjie
Department of Thoracic and Cardiac Surgery, The Second People's Hospital of Changzhou, Affiliated of Nanjing Medical University, Changzhou, China.
Department of Radiology, The Second People's Hospital of Changzhou, Affiliated of Nanjing Medical University, Changzhou, China.
Int J Clin Pract. 2016 Sep;70 Suppl 9B:B50-5. doi: 10.1111/ijcp.12852.
To evaluate image quality and radiation dosage in coronary CT angiography using 80-kVp tube voltage combined with low-concentration contrast media (CM) and iterative reconstruction (IR) for coronary CT angiography (CCTA) and employing dual-source CT without heart-rate control.
154 patients were randomly assigned to Group A (Control Group, 120-kVp tube voltage, high-concentration CM and filtered back projection reconstruction) and Group B (Low-Dose Group, 80 kVp, low-concentration CM and iterative construction). Two experienced radiologists double-blindly evaluated the following parameters: CT attenuation, signal-noise ratio (SNR), contrast-noise ratio (CNR), radiation dose, size-specific dose estimates (SSDE) and total iodine intake. Pearson correlation analysis was used to assess the relationship between SSDE and BMI.
98.1% vessel segments in Group A and 97.6% in Group B passed diagnostics, indicating no significant differences; the average aorta scores and CT attenuation values showed no significant differences between groups. Similar SNR and CNR results were obtained for the two groups, although values were slightly lower in Group A compared with Group B. The Effective Dose in Group B was 63% lower than that in Group A (P<.001). SSDE results were significantly different between the two groups (P<.001) but did not correlate with BMI. Finally, the total iodine intake in Group B was 22.9% lower than that in Group A.
Coronary CTA conducted with a low tube voltage of 80 kVp, a low-concentration CM and IR without heart rate control can achieve images of similar quality to those obtained using standard procedures, significantly reducing the associated radiation dose and iodine intake.
评估在冠状动脉CT血管造影(CCTA)中,使用80 kVp管电压结合低浓度对比剂(CM)以及迭代重建(IR)技术,并采用无需控制心率的双源CT时的图像质量和辐射剂量。
154例患者被随机分为A组(对照组,120 kVp管电压、高浓度CM及滤波反投影重建)和B组(低剂量组,80 kVp、低浓度CM及迭代重建)。两名经验丰富的放射科医生采用双盲法评估以下参数:CT衰减、信噪比(SNR)、对比噪声比(CNR)、辐射剂量、体型特异性剂量估计值(SSDE)和总碘摄入量。采用Pearson相关分析评估SSDE与BMI之间的关系。
A组98.1%的血管节段及B组97.6%的血管节段通过诊断,表明无显著差异;两组的平均主动脉评分和CT衰减值无显著差异。两组获得了相似的SNR和CNR结果,尽管A组的值略低于B组。B组的有效剂量比A组低63%(P<0.001)。两组的SSDE结果存在显著差异(P<0.001),但与BMI无关。最后,B组的总碘摄入量比A组低22.9%。
采用80 kVp的低管电压、低浓度CM及无需控制心率的IR技术进行冠状动脉CTA,可获得与标准程序相似质量的图像,显著降低相关辐射剂量和碘摄入量。