大螺距和双低剂量CT血管成像在心脑一站式联合扫描中的应用研究

目的探讨Force CT大螺距和双低剂量CT血管成像在心脑一站式联合扫描中的应用价值。方法回顾性分析178例患者CTA资料。A组58例:头颈心一站式联合扫描CTA,应用大螺距、双低剂量及前瞻性心电门控行冠状动脉、头颈部动脉一站式联合扫描; B组60例:冠状动脉CTA:前瞻性心电门控行常规冠状动脉成像; C组60例:常规头颈部动脉CTA。对各组图像质量进行主、客观评价,对A组与B组冠状动脉图像质量及A组与C组头颈部动脉图像质量进行主观评分,客观记录并比较各组升主动脉根部、左前降支、颈总动脉分叉处、大脑中动脉M1段图像CT值、对比噪声比（CNR）及图像噪声（SD）,计算并比较各组的辐射剂量（ED）和平均碘摄入量。结果 A组与B组冠状动脉图像质量评分、升主动脉根部及左前降支CT值和图像噪声差异无统计学意义（P>0.05）; A组与C组头颈部动脉图像质量评分、颈总动脉分叉处及大脑中动脉M1段CT值和图像噪声差异均无统计学意义（P>0.05）。A组与（B+C）组辐射剂量、平均碘摄入量差异有统计学意义（P<0.001）,辐射剂量降低约79.7%,平均碘摄入量降低约46.1%。结论大螺距双低剂量CT血管成像心脑一站式检查在保证图像质量的同时大幅度降低了辐射剂量,减少了对比剂碘量的摄入。

Large-Pitch and Dual-Low-Dose CT Angiography in Heart-Brain One-Stop Combined Scanning .

Objective To explore application value of large-pitch and dual-low-dose CT angiography in heart-brain one-stop combined scanning.Methods CTA data of 178 patients were retrospectively analyzed. Group A(n=58):head-neck-heart one-stop combined scanning CTA, using large-pitch, dual low-dose and prospective ECG gating to perform one-stop combined scanning of coronary and head-neck arteries. Group B(n=60):coronary artery CTA, prospective ECG-gated conventional coronary artery imaging. Group C(n=60):conventional head-neck artery CTA. Images quality were evaluated subjectively and objectively. Image quality of coronary arteries in group A and B and head-neck arteries in group A and C were scored subjectively. Image CT value, contrast to noise ratio(CNR)and image noise(SD)of each group were recorded objectively in ascending aortic root, left anterior descending branch, common carotid artery bifurcation and middle cerebral artery M1 segment. Radiation dose(ED)and average iodine intake of each group were calculated and compared.Results There were no statistically significant differences in coronary artery image quality score,CT values of ascending aortic root and left anterior descending branch, and SD between group A and B(P>0.05). There were no significant differences in image quality score, CT values and SD at bifurcation of common artery and M1 segment of middle cerebral artery between group A and C(P>0.05). ED and average iodine intake had statistically significant differences between group A and(B+C)(P>0.001). ED was reduced by about 79.7%, and average iodine intake was reduced by about 46.1%.Conclusion Large-pitch and dual-low-dose CT angiography in heart-brain one-stop combined scanning would maintain image quality and significantly reduce ED and intake of iodine contrast agent.