标题：双低剂量CT主动脉血管造影的应用研究

      作者：梁振华 1，黄钰坚 1，方挺松 1，曹贤东 2，李均洪 1，柯祺 1    广州中医药大学附属佛山市中医院医学影像科CT室 1、病案统计室 2，广东 佛山 528000

      卷次： 2019年30卷13期

      【摘要】 目的 探讨在 64排螺旋 CT应用低管电压、低对比剂剂量进行主动脉血管造影检查的可行性。方法 把佛山市中医院2017年6月至2018年2月期间临床疑诊主动脉病变需行CT主动脉血管造影检查的患者80例，采用随机数表法分为常规组与双低组，每组40例。常规组120 kV，200 mA，对比剂80 mL、注射速率5.0 mL/s；双低组 100 kV，244 mA，对比剂 0.75 mL/kg、注射速率 5.0 mL/s。比较两组患者碘对比剂的使用量、主动脉及其分支血管内碘对比剂的强化程度、图像质量以及辐射剂量的差异。结果 两组患者的主动脉CTA图像均能满足临床诊断要求。双低组患者的主动脉升部、降部、腹腔干、肾动脉水平处腹主动脉、左髂总动脉内所测量的CT值分别为(486.5±88.6) Hu、(460.3±82.7) Hu、(447.4±79.2) Hu、(459.0±86.8) Hu、(454.4±77.9) Hu，常规组对应测量部位的CT值分别为(446.0±46.0) Hu、(420.0±62.3) Hu、(407.9±49.6) Hu、(414.1±73.7) Hu、(409.5±77.2) Hu，双低组的CT值较常规组高约10%，但差异均无统计学意义(P>0.05)；相同部位小动脉的显示双低组明显优于常规组，其图像质量主观评分高于常规组，分别为(4.5±0.5)分和(4.1±0.5)分，差异均有统计学意义(P<0.05)；双低组患者接受的辐射剂量CTDIvol、DLP、ED和对比剂使用量分别为(9.63±1.05) mGy、(609.5±52.5) mGy·cm、(9.1±0.8) mSv和 0.75 mL/kg，常规组对应值为(13.08±1.38) mGy、(820.9±68.5) mGy·cm、(12.3±1.0) mSv和80 mL/kg，双低组患者接受的辐射剂量和对比剂使用量均显著低于常规组，差异均有统计学意义(P<0.05)。结论 64排螺旋CT采用双低剂量行主动脉血管造影的方法可行，其能显著降低患者所接受的辐射剂量及对比剂使用量，且对小动脉的显示明显优于常规扫描方法。
      【关键词】 电子计算机断层扫描；主动脉血管造影；小动脉；低辐射剂量；低对比剂剂量
      【中图分类号】 R445 【文献标识码】 A 【文章编号】 1003—6350（2019）13—1711—04

Application of aortic CT angiography with low tube voltage and low contrast agent dose.
LIANG Zhen-hua 1,HUANG Yu-jian 1, FANG Ting-song 1, CAO Xian-dong 2, LI Jun-hong 1, KE Qi 1. CT Room of Medical ImagingDepartment 1, Medical Records and Statistics Room 2, Foshan Hospital of Traditional Chinese Medicine Affiliated toGuangzhou University of Chinese Medicine, Foshan 528000, Guangdong, CHINA
【Abstract】 Objective To explore the feasibility of aortic angiography with low tube voltage and low contrastagent dose in 64-slice spiral CT. Methods Eighty patients who were clinically suspected as aortic diseases and sched-uled for aortic CT angiography from June 2017 to February 2018 in Foshan Hospital of Traditional Chinese Medicine Af-filiated to Guangzhou University of Chinese Medicine were divided into the conventional group and the dual-low groupby random number table, with 40 cases in each group. In the conventional group, the parameters were tube voltage 120 kV,tube current 200 mA, contrast agent 80 mL, and injection rate 5.0 mL/s; In the dual-low group, the parameters were setas tube voltage of 100 kV, tube current of 244 mA, contrast agent of 0.75 mL/kg, and injection rate at 5.0 mL/s. Furthercomparison were carried out concerning the dosage of iodine contrast agent, the enhancement degree of iodine contrastagent in the aorta and its branches, image quality, and radiation dose of the two groups. Results The aortic CTA imagesof the two groups could both meet the clinical diagnostic requirements. The CT values of aorta ascendens, descendingaorta, truncuscoeliacus, aorta of renal artery level, left common iliac artery were (486.5±88.6) Hu, (460.3±82.7) Hu,(447.4±79.2) Hu, (459.0±86.8) Hu, (454.4±77.9) Hu in the dual-low group, versus (446.0±46.0) Hu, (420.0±62.3) Hu,(407.9±49.6) Hu, (414.1±73.7) Hu, (409.5±77.2) Hu in the conventional group. The CT values were about 10% higher inthe dual-low group than those of the conventional group (P>0.05). The display of arterioles at the same site in the du-al-low group was better than that in the conventional group, and the subjective score of image quality in dual-low groupwas higher than that in conventional group: (4.5±0.5) vs (4.1±0.5), P<0.05. The doses of CTDIvol, DLP, ED, and con-trast agent used in the dual-low group were (9.63±1.05) mGy, (609.5±52.5) mGy·cm, (9.1±0.8) mSv, and 0.75 mL/kg,versus (13.08±1.38) mGy, (820.9±68.5) mGy·cm, (12.3±1.0) mSv, and 80 mL/kg in the conventional group. The effec-tive radiation dose and contrast agent dose of the patients in the double-low group were significantly lower than those inthe conventional group (P<0.05). Conclusion The aortic angiography with dual-low dose in 64-slice spiral CT is feasi-ble, which can significantly reduce the radiation dose and the amount of contrast medium received by patients, with bet-ter display of arterioles than the conventional scanning.
      【Key words】 CT; Aortic angiography; Arteriole;