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低电压(80千伏峰值)腹部盆腔计算机断层扫描可使有对比剂肾病风险的患者的对比剂剂量减少60%。

Low-voltage (80-kVp) abdominopelvic computed tomography allows 60% contrast dose reduction in patients at risk of contrast-induced nephropathy.

作者信息

Araki Kazumi, Yoshizako Takeshi, Yoshida Rika, Tada Keiji, Kitagaki Hajime

机构信息

Department of Radiology, Shimane University Faculty of Medicine, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan.

Department of Radiology, Shimane University Faculty of Medicine, P.O. Box 00693-8501, 89-1 Enyacho, Izumo, Japan.

出版信息

Clin Imaging. 2018 Sep-Oct;51:352-355. doi: 10.1016/j.clinimag.2018.05.027. Epub 2018 Jun 9.

Abstract

PURPOSE

The purpose of this study was to evaluate the quality of image in abdominopelvic late phase computed tomography (CT) with a low tube voltage plus low dose contrast medium (CM) protocol (80-kVp, 60% CM). A compared with the conventional protocol (120-kVp, 100% CM) B in the same patients.

MATERIAL AND METHODS

This study included with 22 patients {36 to 77 kg (mean: 55.5 kg)} who had renal insufficiency and had experience of performance conventional CT without renal insufficiency during pre-18 months. The CT value of the portal vein, liver parenchyma, abdominal aorta, psoas muscle was measured. The estimated mean CNR (contrast-to-noise ratios), FOM (figure of merit), DLP (dose length product) and ED (effective dose) were compared between protocol A and B. Moreover, two radiologists assessed the visual quality of the CT images.

RESULTS

The mean DLP and ED in the protocol B was about 50% lower than that in the protocol A (p < 0.01). The mean CT value of the portal vein and abdominal aorta in the protocol B were significantly higher than that in the protocol A (p < 0.01). All of the FOM in the protocol B was significantly higher than that in the protocol A (p < 0.01). However, there was no significant difference in the mean CNR and visual quality between protocol A and B.

CONCLUSION

Performance of abdominopelvic CT using a low tube voltage plus reduced CM dose (80-kVp, 60% CM) achieved reduction of the radiation dose without impairing image quality in relatively light weight group.

CLINICAL RELEVANCE/APPLICATION: In abdominopelvic CT, protocol of low tube voltage (80-kVp) plus iodine dose reduction (60%) is able to provide the same quality of traditional protocols, also able to reducing radiation exposure (50%).

摘要

目的

本研究旨在评估采用低管电压加低剂量对比剂(CM)方案(80 kVp,60% CM)的腹盆腔晚期计算机断层扫描(CT)图像质量。在同一患者中与传统方案(120 kVp,100% CM)进行比较。

材料与方法

本研究纳入22例患者{体重36至77 kg(平均:55.5 kg)},这些患者有肾功能不全,且在18个月前有过无肾功能不全时进行传统CT检查的经历。测量门静脉、肝实质、腹主动脉、腰大肌的CT值。比较方案A和方案B之间的估计平均对比噪声比(CNR)、品质因数(FOM)、剂量长度乘积(DLP)和有效剂量(ED)。此外,两名放射科医生评估CT图像的视觉质量。

结果

方案B的平均DLP和ED比方案A低约50%(p < 0.01)。方案B中门静脉和腹主动脉的平均CT值显著高于方案A(p < 0.01)。方案B的所有FOM均显著高于方案A(p < 0.01)。然而,方案A和方案B之间的平均CNR和视觉质量没有显著差异。

结论

在相对体重较轻的人群中,采用低管电压加降低CM剂量(80 kVp,60% CM)进行腹盆腔CT检查,在不损害图像质量的情况下实现了辐射剂量的降低。

临床相关性/应用:在腹盆腔CT中,低管电压(80 kVp)加碘剂量减少(60%)的方案能够提供与传统方案相同的质量,同时能够减少50%的辐射暴露。

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