Liu J B, Zhang J W, Zhang X H, Zhou W, Yuan B, Fan L J
TEDA International Cardiovascular Hospital, Tianjin 300457, China.
Zhonghua Yi Xue Za Zhi. 2020 Nov 24;100(43):3448-3452. doi: 10.3760/cma.j.cn112137-20200411-01161.
To investigate the feasibility of coronary computed tomography angiography (CCTA) with the individualized contrast medium injection scheme based on body mass and iodine flow rate by using wide detector CT at 100 kV. From May 2018 to July 2018,270 patients with clinically suspected coronary artery disease underwent CCTA in TEDA International Cardiovascular Hospital. They were randomly divided into three groups, 90 cases in each group: group A was 0.5 ml/kg, group B was 0.6 ml/kg, the flow rate of contrast medium injection in group A and group B was (body mass×25 mg)/the concentration of contrast medium,group C was 0.8 ml/kg and the flow rate of contrast medium was 5 ml/s. Iohexol (iodine concentration 350 mgI/ml) was used in all three groups. The CT values of the aorta root in the three groups, the CT value of the middle segment of LAD and RCA, SNR、CNR、 of the aortic root, subjective score of coronary artery and effective dose (ED) were compared. There was no significant difference in CT value of aortic root, CT value of middle LAD and RCA, SNR、CNR、 of the aortic root, subjective score of coronary artery among group A, group B and group C (all 0.05). The flow rates of the three groups of contrast agents were statistically different (4.5±0.5 vs 4.5±0.5 vs 5, 0.015), and there was no statistical difference between group A and group B (0.05) but lower than group C (0.015); the amount of contrast agent in the three groups was statistically different (32±3 vs 38±4 vs 53±7, 0.001), group A<B Group<C group; there was no significant difference in ED between the three groups (1.5±0.5 vs 1.5±0.6 vs 1.3±0.6, 0.613). CCTA imaging with a wide body detector based on a 0.5 ml/kg contrast agent dosage and a flow rate of ((body mass × 25)/350) ml/s individualized injection scheme can ensure the image quality while reducing the total amount of contrast agent and realizing individualized iodine flow rate.
为探讨基于体重和碘流率的个体化对比剂注射方案在100 kV宽探测器CT冠状动脉计算机断层扫描血管造影（CCTA）中的可行性。2018年5月至2018年7月，270例临床疑似冠心病患者在泰达国际心血管病医院接受CCTA检查。他们被随机分为三组，每组90例：A组为0.5 ml/kg，B组为0.6 ml/kg，A组和B组对比剂注射流率为（体重×25 mg）/对比剂浓度，C组为0.8 ml/kg且对比剂流率为5 ml/s。三组均使用碘海醇（碘浓度350 mgI/ml）。比较三组主动脉根部CT值、左前降支和右冠状动脉中段CT值、主动脉根部的信噪比（SNR）、对比噪声比（CNR）、冠状动脉主观评分及有效剂量（ED）。A组、B组和C组之间主动脉根部CT值、左前降支中段和右冠状动脉CT值、主动脉根部的SNR、CNR、冠状动脉主观评分均无显著差异（均P>0.05）。三组对比剂流率有统计学差异（4.5±0.5 vs 4.5±0.5 vs 5，P=0.015），A组和B组之间无统计学差异（P>0.05）但低于C组（P=0.015）；三组对比剂用量有统计学差异（32±3 vs 38±4 vs 53±7，P=0.001），A组<B组<C组；三组之间ED无显著差异（1.5±0.5 vs 1.5±0.6 vs 1.3±0.6，P=0.613）。基于0.5 ml/kg对比剂用量和（（体重×25）/350）ml/s个体化注射方案的宽体探测器CCTA成像可在保证图像质量的同时减少对比剂总量并实现个体化碘流率。
