摘要
目的探究不同对比剂注射方案对冠状动脉计算机断层扫描造影(CCTA)检查图像质量、检查准确率的影响。方法采用便利抽样法,选取我院2020年3月—2022年7月拟行CCTA检查的120例患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组60例。对照组患者采用固定剂量及流速的注射方案,观察组患者采用基于体表面积(BSA)的个体化注射方案,比较2组患者冠脉不同测量部位CT值、右心室及上腔静脉伪影分级、室间隔显示评分、图像质量客观指标[对比噪声比(CNR)]与主观评分、辐射剂量及碘负荷,将CCTA检查结果与金标准(临床随访或冠脉造影)进行对比,评估检查准确率。结果2组患者主动脉及右冠状动脉(RCA)的CT值差异无统计学意义(P>0.05),观察组患者的冠脉左主干(LM)、左前降支(LAD)、左旋支(LCX)的CT值均大于对照组(P<0.05);观察组患者右心室及上腔静脉伪影分级、室间隔显示评分均优于对照组(P<0.05);观察组患者CNR大于对照组(P<0.05),而观察组患者的图像质量主观评分中的清晰度、伪影、冠脉显示和冠脉分支可视化各项评分与对照组比较,差异均无统计学意义(P>0.05);观察组患者CT剂量指数(CTDI)、CT剂量长度乘积(DLP)、有效辐射剂量、碘负荷均小于对照组(P<0.05);观察组、对照组中分别有57例、54例患者的诊断结果与金标准相符,2组患者的诊断准确率比较,差异无统计学意义(P>0.05)。结论基于BSA的个体化对比剂注射方案相比于传统固定剂量和流速方案,可提高CCTA检查的图像质量,减少患者的辐射剂量和碘负荷,具有较高的临床应用价值。
Objective To investigate the effect of different contrast medium injection regimens on image quality and accuracy of coronary CT angiography(CCTA).Methods A total of 120 patients scheduled for CCTA from March 2020 to July 2022 were selected as the study participants by convenience sampling.They were allocated to the observation group and control group by a random number table,with 60 cases in each group.The control group received the injection regimen with a fixed dose and flow rate,and the observation group received the individualized injection regimen based on body surface area(BSA).The CT values of different measurement sites of the coronary artery,right ventricular and superior vena cava artifact grades,interventricular septum display scores,objective(contrast-to-noise ratio[CNR])and subjective indices of image quality scores,radiation doses,and iodine loads were compared between the two groups.The CCTA examination results were compared with the gold standard(clinical follow-up or coronary angiography)to evaluate the examination accuracy.Results No significant difference was observed in the CT values of the aorta and right coronary artery(RCA)between the two groups(P>0.05).The CT values of the left main coronary artery(LM),left anterior descending artery(LAD),and left circumflex artery(LCX)in the observation group were greater than those in the control group(P<0.05).The right ventricular and superior vena cava artifact grade and interventricular septum display scores in the observation group were superior to those in the control group(P<0.05).The CNR in the observation group was greater than that in the control group(P<0.05).The clarity,artifact,coronary artery display,and coronary artery branch visualization scores in the subjective image quality score in the observation group were not significantly different from those in the control group(P>0.05).The CT dose index(CTDI),CT dose length product(DLP),effective radiation dose,and iodine load in the observation group were less than those in the control group(P<0.05).The diagnostic results of 57 patients in the observation group and 54 patients in the control group were consistent with the gold standard,and no significant difference was found in the diagnostic accuracy between the groups(P>0.05).Conclusion The BSA-based individualized contrast medium injection regimen can improve the image quality of CCTA examination and reduce the radiation dose and iodine load of patients compared with the traditional fixed dose and flow rate regimen,holding promise for a wider clinical application.
作者
刘月
张彦斌
梁子懿
Liu Yue;Zhang Yanbin;Liang Ziyi(Department of Radiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Peritoneal Oncology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《保健医学研究与实践》
2023年第10期77-82,共6页
Health Medicine Research and Practice
基金
北京市优秀人才培养资助集体项目(2017400003235J007)
作者简介
第一作者:刘月,E-mail:liuyue3460@bjsjth.cn。
