Department of Medicine, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California.
Department of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
Tex Heart Inst J. 2022 Mar 1;49(2). doi: 10.14503/THIJ-18-6793.
Computed tomographic coronary artery calcium scanning enables cardiovascular risk stratification; however, exposing patients to high radiation levels is an ongoing concern. New-generation computed tomographic systems use lower radiation doses than older systems do. To quantify comparative doses of radiation exposure, we prospectively acquired images from 220 patients with use of a 64-slice GE LightSpeed VCT scanner (control group, n=110) and a 256-slice GE Revolution scanner (study group, n=110). The groups were matched for age, sex, and body mass index; statistical analysis included t tests and linear regression. The mean dose-length product was 21% lower in the study group than in the control group (60.2 ± 27 vs 75.9 ± 22.6 mGy·cm; P <0.001) and also in each body mass index subgroup. Similarly, the mean effective radiation dose was 21% lower in the study group (0.84 ± 0.38 vs 1.06 ± 0.32 mSv) and lower in each weight subgroup. After adjustment for sex, women in the study group had a lower dose-length product (50.4 ± 23.4 vs 64.7 ± 27.6 mGy·cm) than men did and received a lower effective dose (0.7 ± 0.32 vs 0.9 ± 0.38 mSv) (P=0.009). As body mass index and waist circumference increased, so did doses for both scanners. Our study group was exposed to radiation doses lower than the previously determined standard of 1 mSv, even after adjustment for body mass index and waist circumference. In 256-slice scanning for coronary artery calcium, radiation doses are now similar to those in lung cancer screening and mammography.
计算机断层扫描冠状动脉钙化扫描可进行心血管风险分层;然而,使患者暴露于高辐射水平仍然是一个持续存在的问题。新一代计算机断层扫描系统使用的辐射剂量低于旧系统。为了量化比较辐射暴露剂量,我们前瞻性地从使用 64 层 GE LightSpeed VCT 扫描仪(对照组,n=110)和 256 层 GE Revolution 扫描仪的 220 名患者中获取图像(研究组,n=110)。两组在年龄、性别和体重指数方面相匹配;统计分析包括 t 检验和线性回归。研究组的剂量长度乘积比对照组低 21%(60.2±27 与 75.9±22.6 mGy·cm;P<0.001),且在每个体重指数亚组中也是如此。同样,研究组的有效辐射剂量平均降低 21%(0.84±0.38 与 1.06±0.32 mSv),且在每个体重亚组中也更低。在校正性别后,研究组中的女性剂量长度乘积(50.4±23.4 与 64.7±27.6 mGy·cm)低于男性,且接受的有效剂量(0.7±0.32 与 0.9±0.38 mSv)也更低(P=0.009)。随着体重指数和腰围的增加,两种扫描仪的剂量都增加了。即使在校正体重指数和腰围后,我们的研究组接受的辐射剂量仍低于先前确定的 1 mSv 标准。在冠状动脉钙化的 256 层扫描中,辐射剂量现在与肺癌筛查和乳房 X 光检查相似。