多层螺旋CT联合多模型迭代重建算法用于高体质量指数患者冠状动脉成像

目的 观察多层螺旋CT （MSCT）联合多模型迭代重建算法（ASIR-V）对高体质量指数（BMI）患者（26~30 kg/m²）行冠状动脉成像（CCTA）的价值。方法 将60例高BMI患者分为研究组（n=30）和对照组（n=30）行CCTA。研究组管电压100 kVp，根据BMI及体质量确定对比剂用量及流率；对照组管电压120 kVp，对比剂剂量70 ml，流率5 ml/s。分别采用权重20%、40%、60%及80% ASIR-V重建2组图像，比较组间及组内图像客观和主观质量评价差异及2组辐射有效剂量（ED）。结果 研究组ED[（2.65±0.64）mSv]及对比剂剂量[（61.84±9.17）ml]分别较对照组[（4.53±0.84）mSv、（70.0±0.00）ml]降低41.50%和11.66%（P均<0.05）。相同权重ASIR-V重建图像中研究组各血管节段CT值均高于对照组（t=5.11~6.86，P均<0.05），而信噪比（SNR）、对比噪声比（CNR）及主观评价与对照组差异均无统计学意义（P均>0.05）。随ASIR-V权重增加，2组各血管节段CT值均无明显增加（P均>0.05），SNR及CNR逐渐增加（P均<0.05）；组内不同权重ASIR-V图像主观评分差异均有统计学意义（P均<0.01）。结论 MSCT联合ASIR-V以100 kVp管电压对高BMI患者行CCTA可在显著降低患者ED及对比剂剂量的同时获得满意图像质量。

Multi-slice spiral CT combined with adaptive statistical reconstruction Veo algorithm for coronary artery angiography in patients with high body mass index

Objective To investigate the application value of multi-slice spiral CT (MSCT) combined with adaptive statistical reconstruction Veo (ASIR-V) algorithm for coronary artery CT angiography (CCTA) in patients with high body mass index (BMI). Methods Totally 60 high BMI (26-30 kg/m²) patients who underwent CCTA were divided into study group (n=30) and control group (n=30). In study group, the tube voltage was 100 kVp, and the contrast agent dose and injection flow rate were determined according to BMI and body mass, while in control group, the tube voltage was 120 kVp, and the contrast dose was fixed at 70 ml and injection flow rate was 5 ml/s. The images were reconstructed with ASIR-V weights of 20%, 40%, 60% and 80%, respectively. The objective and subjective quality evaluation of images were compared between and within groups, and the radiation effective dose (ED) of 2 groups were analyzed. Results Compared with control group ([4.53±0.84] mSv,[70.0±0.00)] ml), ED ([2.65±0.64]mSv) and contrast agent dose ([61.84±9.17]ml) of study group decreased by 41.50% and 11.66%, respectively (both P<0.05). For ASIR-V reconstruction images with the same weight, CT values of vascular segments in study group were higher than those in control group (t=5.11-6.86, all P<0.05), while no significant difference of signal-to-noise ratio (SNR), contrast-noise ratio (CNR) nor subjective evaluation was found groups (all P>0.05). With the increase of ASIR-V weight, CT values of vascular segments in 2 groups did not increase significantly (all P>0.05), while SNR and CNR gradually increased (all P<0.05). Subjective evaluation of ASIR-V images with different weights were significantly different within groups (all P<0.01). Conclusion MSCT combined with ASIR-V under 100 kVp tube voltage could obtain high image quality and significantly reduce ED and contrast agent dose in CCTA of high BMI patients.