Wang Y, Di A H, Zhang Y
Department of Radiology, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Yi Xue Za Zhi. 2022 Nov 22;102(43):3457-3462. doi: 10.3760/cma.j.cn112137-20220729-01649.
To investigate the feasibility of reducing the iodine delivery rate (IDR) of coronary CT angiography(CCTA)with 100 kVp to 60% of 120 kVp standard. A total of 205 patients (105 males and 100 females, aged from 23 to 87 years) underwent CCTA due to suspected coronary artery disease in Department of Radiology of Peking University Third Hospital from February to July 2022 were enrolled. Those patients were divided into five subgroups according to their body weight: <50 kg, 50 to 59 kg, 60 to 69 kg, 70 to 79 kg and ≥ 80 kg, respectively. All the cases were scanned with 100 kVp tube voltage and combined with mixed iterative reconstruction technology KARL 3D. The IDR injection protocol was set to 60% of the 120 kVp IDR standard (10% lower than the guideline), and the IDR of each group was 0.9, 1.0, 1.1, 1.3 and 1.4 gI/s, respectively. The CT attenuations (CT value) and noise (SD value) of the aortic root, proximal left anterior descending branch and the distal segments of the right coronary artery, the signal-to-noise ratio (SNR) and contrast noise ratio (CNR) of proximal left anterior descending branch and the distal segments of the right coronary artery, the whole subjective image quality scores of the coronary artery, and effective dose (ED) of CCTA in the five groups were compared. The One-way ANOVA or Kruskal-walls test was used for statistical analysis. There was no significant difference in CT attenuations and noise of aortic root, proximal left anterior descending and the distal segments of the right coronary artery, SNR and CNR of proximal left anterior descending branch and the distal segments of the right coronary artery, and subjective image quality scores among the five groups (all >0.05). The difference of the dosage of contrast medium and ED among the five groups were statistically significant (all <0.05). The dosage of contrast medium in the five groups were 30, 34, 38, 43 and 48 ml, and the ED in the five groups was 2.24 (1.88, 2.56), 2.62 (2.24, 3.17), 2.70 (2.48, 3.20), 4.13 (3.85, 4.40) and 4.44 (4.01, 5.02) mSv, respectively. It is feasible to reduce the IDR injection protocol of coronary CT angiography with 100 kVp to 60% of the standard injection protocol with 120 kVp, which is worthy of promotion.
为探讨将100 kVp冠状动脉CT血管造影（CCTA）的碘输送率（IDR）降低至120 kVp标准的60%的可行性。选取2022年2月至7月在北京大学第三医院放射科因疑似冠状动脉疾病接受CCTA检查的205例患者（男105例，女100例，年龄23至87岁）。根据体重将这些患者分为五个亚组：分别为<50 kg、50至59 kg、60至69 kg、70至79 kg和≥80 kg。所有病例均采用100 kVp管电压扫描，并结合混合迭代重建技术KARL 3D。将IDR注射方案设定为120 kVp IDR标准的60%（比指南低10%），每组的IDR分别为0.9、1.0、1.1、1.3和1.4 gI/s。比较五组患者主动脉根部、左前降支近端和右冠状动脉远端的CT衰减（CT值）和噪声（SD值），左前降支近端和右冠状动脉远端的信噪比（SNR）和对比噪声比（CNR），冠状动脉的整体主观图像质量评分以及CCTA的有效剂量（ED）。采用单因素方差分析或Kruskal-walls检验进行统计学分析（此处英文原文有误，应为Kruskal-Wallis检验）。五组患者主动脉根部、左前降支近端和右冠状动脉远端的CT衰减和噪声，左前降支近端和右冠状动脉远端的SNR和CNR以及主观图像质量评分均无显著差异（均>0.05）。五组之间造影剂用量和ED的差异具有统计学意义（均<0.05）。五组的造影剂用量分别为30、34、38、43和48 ml，五组的ED分别为2.24（1.88，2.56）、2.62（2.24，3.17）、2.70（2.48，3.20）、4.13（3.85，4.40）和4.44（4.01，5.02）mSv。将100 kVp冠状动脉CT血管造影的IDR注射方案降低至120 kVp标准注射方案的60%是可行的，值得推广。
