摘要
目的分析低浓度对比剂对头颈部CT血管成像(CTA)患者受辐射剂量、对比剂肾损伤(CIN)发生率的影响。方法将2022年1月~2022年12月入院的68例行头颈部CTA检查者随机分为低浓度组(34例)与高浓度组(34例),低浓度组使用对比剂为碘克沙醇320mgl/mL,管电压为100kVp,高浓度组对比剂为碘海醇350mg l/mL,管电压为120kVp。比较两组图像主观评分及客观图像质量[各部位CT值、信噪比(SNR)、对比噪声比(CNR)]差异,记录两组辐射剂量[CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效剂量(ED)]及CIN等不良反应发生率,并评估两组超重及肥胖人群的SNR、CNR。结果两组图像主观评分比较,差异无统计学意义(P>0.05),2名放射科医生对两组图像判断的一致性均良好(P<0.05)。低浓度组升主动脉、颈总动脉、大脑中动脉测量的CT值及SNR、CNR均高于高浓度组(P<0.05),CTDIvol、DLP、ED则低于高浓度组(P<0.05)。两组不良反应及超重、肥胖人群各血管SNR、CNR比较,差异无统计学意义(P>0.05)。结论碘克沙醇320mgl/mL碘对比剂及100kVp管电压,结合三维自适应迭代剂量降低算法重建,可实现高图像质量及低辐射剂量的双重优点,对降低CIN发生风险也有利,但对于超重、肥胖受检者可能不适用。
Objective To analyze the effects of low-concentration contrast agent on radiation dose and incidence rate of contrast-induced nephropathy(CIN)in patients with head and neck CT angiography(CTA).Methods 68 patients who underwent head and neck CTA examination in the hospital from January 2022 to December 2022 were randomly divided into low-concentration group(34 cases)and high-concentration group(34 cases).The contrast agent was 320mgl/mL and tube voltage was 100kVp in low-concentration group,and the contrast agent was 350mgl/mL and tube voltage was120kVp in high-concentration group.The differences in image subjective score and objective image quality[CT value,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)at each part]were compared between the two groups,and the radiation dose[CT volume dose index(CTDIvol),dose length product(DLP),effective dose(ED)]and the incidence rates of CIN and other adverse reactions were recorded in the two groups.SNR and CNR of overweight and obese people were evaluated in both groups.Results There was no statistical significant difference in the image subjective score between the two groups(P>0.05),and the two radiologists had good consistency in the judgment of the two groups of images(P<0.05).The CT values,SNR values and CNR values of ascending aorta,common carotid artery and middle cerebral artery in low-concentration group were higher than those in high-concentration group(P<0.05)while the CTDIvol,DLP and ED were lower than those in high-concentration group(P<0.05).There were no statistical differences in the adverse reactions and SNR and CNR of overweight and obese people between the two groups(P>0.05).Conclusion 320mgI/mL iodine contrast agent and 100kVp tube voltage combined with three-dimensional adaptive iterative dose reduction algorithm reconstruction can achieve the double advantages of high image quality and low radiation dose,and it is also beneficial to reducing the risk of CIN,but it may not be suitable for overweight and obese subjects.
作者
蔡敏华
崔毛毛
叶俊杰
Cai Min-hua;Cui Mao-mao;Ye Jun-jie(Wuhan Third Hospital,Wuhan 430000,Hubei Province,China)
出处
《中国CT和MRI杂志》
2024年第2期52-54,共3页
Chinese Journal of CT and MRI
基金
湖北省卫生健康委员会中医药科研项目(ZY2021M068)。
关键词
CTA
头颈部
对比剂
低浓度
图像质量
辐射剂量
对比剂肾损伤
CTA
Head and Neck
Contrast Agent
Low-concentration
Image Quality
Radiation Dose
Contrast-induced Nephropathy
