Radiology Department, Huadong Hospital, Affiliated to Fudan University, Shanghai, China.
Radiology Department, West China Hospital, Affiliated to SiChuan University, Chengdu, China.
Acad Radiol. 2021 Mar;28(3):364-369. doi: 10.1016/j.acra.2020.02.014. Epub 2020 Mar 21.
Radiation exposure from coronary computed tomography angiography (CCTA) remains a cause for concern. The objective of this study was to investigate whether using the coronary artery calcium score scan (CACS) would reduce the radiation dose for CCTA scanning and the overall radiation exposure (ORE).
In total, 256 patients were examined with a third-generation dual-source CT (n = 200) or 256-row CT (n = 56), among whom 105 (Group A) and 28 patients (Group B), respectively, underwent CCTA with CACS for field of view planning. The remaining patients, with the scout view for field of view planning, constituted Group A1 and B1. The scanning parameter settings were standardized between groups.
Shorter scan lengths were observed in Group A (9.98 ± 0.79 cm) compared to Group A1 (13.64 ± 1.79 cm; p < 0.001), which also resulted in a lower dose-length product (DLP) in Group A (115.04 ± 64.13) relative to Group A1 (138.67 ± 68.87; p < 0.05). Similarly, shorter scan lengths were found in Group B (14.92 ± 1.17 cm) compared to Group B1 (15.79 ± 0.63 cm; p = 0.001); this resulted in a lower DLP (322.07 ± 45.39) compared to Group B1 (354.34 ± 65.27; p = 0.036). The CACS resulted in an increase in ORE in both groups.
CACS may have a critical role in the reduction of radiation dose in CCTA scanning, but the potential effectiveness of CACS in reducing ORE is weak.
冠状动脉计算机断层扫描血管造影术（CCTA）的辐射暴露仍然令人担忧。本研究旨在探讨冠状动脉钙化评分扫描（CACS）是否会降低 CCTA 扫描的辐射剂量和总辐射暴露（ORE）。
共对 256 例患者进行了第三代双源 CT（n=200）或 256 排 CT（n=56）检查，其中 105 例（A 组）和 28 例（B 组）分别进行了 CACS 指导下的 CCTA 扫描，以规划视野。其余仅行扫描野定位的患者为 A1 组和 B1 组。各组间扫描参数设置标准化。
A 组的扫描长度较 A1 组更短（9.98±0.79cm 比 13.64±1.79cm；p<0.001），导致 A 组的剂量长度乘积（DLP）也较低（115.04±64.13 比 138.67±68.87；p<0.05）。同样，B 组的扫描长度也短于 B1 组（14.92±1.17cm 比 15.79±0.63cm；p=0.001），导致 B 组的 DLP 也较低（322.07±45.39 比 354.34±65.27；p=0.036）。CACS 在两组中均导致 ORE 增加。
CACS 可能在降低 CCTA 扫描的辐射剂量方面发挥重要作用，但 CACS 降低 ORE 的潜在效果较弱。
