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心血管 CT 检查的辐射暴露:常规 64 层 MDCT 与第三代双源 MDCT 的比较。

Radiation exposure related to cardiovascular CT examination: comparison between conventional 64-MDCT and third-generation dual-source MDCT.

机构信息

Department of Radiological Sciences, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy.

Department of Health Physics, Azienda Ospedaliero Universitaria "Ospedali Riuniti", 60126, Ancona, Italy.

出版信息

Radiol Med. 2019 Aug;124(8):753-761. doi: 10.1007/s11547-019-01036-6. Epub 2019 Apr 22.

Abstract

PURPOSE

To compare radiation exposure associated with daily practice cardiovascular (CV) examinations performed on two different multidetector computed tomography (MDCT) scanners, a conventional 64-MDCT and a third-generation dual-source (DS) MDCT.

MATERIALS AND METHODS

In this retrospective study, 1458 patients who underwent CV examinations between January 2017 and August 2018 were enrolled. A single-source 64-MDCT (Lightspeed VCT, GE) scan was performed in 705 patients from January to August 2017 (207 coronary examinations and 498 vascular examinations) and 753 patients underwent third-generation 192 × 2-DSCT (Somatom FORCE, Siemens) scan from January to August 2018 (302 coronary examinations and 451 vascular examinations). Volume CT dose index (CTDI), dose length product (DLP), effective dose (ED), tube voltage (TV) and exposure time (ET), pitch factor (PF) were registered for each patient. Student's t test was used to compare mean values between each corresponding group of MDCT and DSCT.

RESULTS

In coronary examinations with DSCT, CTDI was 24.4% lower (23.1 mGy vs 30.6 mGy, p < 0.0001) and DLP and ED reductions were 35.6% than with MDCT (465.0 mGy * cm vs 732.3 mGy * cm and 6.5 mSv and 10.3 mSv; vs p < 0.0001). Concerning scan parameters, kVp and ET reductions were 12.7% and 69.4%, respectively (p < 0.0001); PF increase was 73.8% (p < 0.0001). In all vascular studies, DSCT, compared with MDCT, permitted to reduce CTDI from 43.5 to 70.6%; DLP and ED reductions were from 50.3 to 73.1%; kVp and ET decreases were from 10.7 to 32.5% and from 26.3 to 68.7%. PF increase was from 16.7 to 58.1% (all differences with p < 0.0001).

CONCLUSIONS

In daily practice, CV examinations CTDI, DLP, ED, ET and TV were lower and PF was higher with 192 × 2-DSCT compared to 64-MDCT.

摘要

目的

比较在两种不同的多排螺旋 CT(MDCT)扫描仪上进行日常心血管(CV)检查时的辐射暴露情况,一种是传统的 64-MDCT,另一种是第三代双源(DS)MDCT。

材料和方法

本回顾性研究纳入了 1458 名 2017 年 1 月至 2018 年 8 月期间进行 CV 检查的患者。2017 年 1 月至 8 月期间,705 名患者接受了单源 64-MDCT(Lightspeed VCT,GE)扫描(207 例冠状动脉检查和 498 例血管检查),2018 年 1 月至 8 月期间,753 名患者接受了第三代 192×2-DSCT(Somatom FORCE,Siemens)扫描(302 例冠状动脉检查和 451 例血管检查)。为每位患者记录容积 CT 剂量指数(CTDI)、剂量长度乘积(DLP)、有效剂量(ED)、管电压(TV)和曝光时间(ET)、螺距因子(PF)。使用 Student's t 检验比较每组 MDCT 和 DSCT 的平均值。

结果

在使用 DSCT 进行冠状动脉检查时,CTDI 降低了 24.4%(23.1 mGy 比 30.6 mGy,p < 0.0001),DLP 和 ED 降低了 35.6%(465.0 mGycm 比 732.3 mGycm 和 6.5 mSv 比 10.3 mSv,p < 0.0001)。在扫描参数方面,kVp 和 ET 分别降低了 12.7%和 69.4%(p < 0.0001),PF 增加了 73.8%(p < 0.0001)。在所有血管研究中,与 MDCT 相比,DSCT 可使 CTDI 降低 43.5%至 70.6%,DLP 和 ED 降低 50.3%至 73.1%,kVp 和 ET 降低 10.7%至 32.5%和 26.3%至 68.7%,PF 增加 16.7%至 58.1%(所有差异均 p < 0.0001)。

结论

在日常实践中,与 64-MDCT 相比,192×2-DSCT 进行 CV 检查时的 CTDI、DLP、ED、ET 和 TV 更低,PF 更高。

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