• 四川大學(xué)華西醫(yī)院放射科（成都，610041）;

【摘要】　目的　 評價64層螺旋CT低劑量冠狀動脈血管成像的價值。　方法　 2009年1-6月157例患者隨機分為3組，常規(guī)劑量組（A組）管電流量采用1 000 mAs，兩個低劑量組（B、C組）分別采用800、600 mAs。對3組的圖像質(zhì)量、噪聲、CT劑量指數(shù)（CTDI）、劑量長度乘積（DLP）和有效劑量（ED）進行評估。　結(jié)果　 A、B、C組圖像噪聲分別為20.50±3.23、23.02±3.05和26.28±2.58，組間差異均無統(tǒng)計學(xué)意義（P gt;0.05）；A、B、C組的CTDI分別為（58.7±0.23）、（46.98±2.27）、（35.28±3.56） mGy，DLP分別為（1 050.88±89.63）、（846.21±57.86）、（641.13±32.15） mGy?cm，ED分別為（14.78±2.56）、（11.85±1.87）、（8.98±1.15） mSv，B、C組的CTDI、DLP、ED均明顯低于常規(guī)劑量A組（P lt;0.05），C組的CTDI、DLP、ED均為3組中最低值。　結(jié)論　 64層螺旋CT冠狀動脈血管檢查，采用600 mAs管電流量獲得的冠脈圖像既可滿足診斷需要，又可使患者接受的輻射劑量降低。
【Abstract】　Objective　 To evaluate the best tube current for low-dose radiation CT in coronary artery imaging by 64-slices multi-detector CT.　Methods　 From January to June 2009, a total of 157 consecutive patients were randomly divided into 3 groups: group A (conventional group): 1 000 mAs; group B: 800 mAs; group C: 600 mAs. The image quality, noise, CT dose index (CTDI), dose length product (DLP) and effective dose (ED) in each group were measured and compared respectively.　Results　 The image noise scores in group A, B, and C were (20.50±3.23), (23.02±3.05) and (26.28±2.58), respectively. There was no statistically significant difference among the three groups in the two indexes (P gt;0.05). The CTDI in group A, B and C were (58.7±0.23), (46.98±2.27), and (35.28±3.56) mGy, respectively; the DLP in each were (1 050.88±89.63), (846.21±57.86), and (641.13±32.15) mGy?cm, respectively; the Ed were (14.78±2.56), (11.85±1.87), and (8.98±1.15) mSv, respectively. All of the differences among the three groups in CTDI, DLP and ED were statistically significant (P lt;0.05).　Conclusion　 The image with 600 mAs as tube current in the coronary artery imaging of 64-slices multi-detector CT could fulfill the need of the diagnosis, and the radiation dose is apparently lower than the conventional scan.

引用本文： 袁元,李真林,鄧莉萍,趙瑾. 64層螺旋CT低劑量冠狀動脈血管成像方案探討. 華西醫(yī)學(xué), 2011, 26(1): 18-21. doi: 復(fù)制

1. 　Weustink AC, Mollet NR, Pugliese F, et al. Optimal electrocardiographic pulsing windows and heart rate: effect on image quality and radiation exposure at dual-source coronary CT angiography[J]. Radiology, 2008, 248(3): 792-798.
2. 　Alkadhi H, Stolzmanna P, Scheffel H, et al. Radiation dose of cardiac dual-source CT: The effect of tailoring the protocol to patient-specific parameters[J]. Eur J Radiol, 2008, 68(3): 385-391.
3. 　Schoepf UJ, Zwerner PL, Savino G, et al. Coronary CT angiography[J]. Radiology, 2007, 244(1): 48-63.
4. 　Prokop M. Radiation dose in computed tomography: risks and challenges[J]. Radiology, 2008, 48(3): 229-242.
5. 　Catalano C, Francone M. Ascareli A, et al. Optimizing radiation-dose and image quality[J]. Eur Radiol, 2007, 17(6): 26-32.
6. 　Austen WG, Edwards JE, Frey RL, et al. A reporting system on patients evaluated for coronary artery disease: report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association[J]. Circulation, 1975, 51(4): 5-40.
7. 　趙原, 蒲紅, 謝坪. 雙源CT在冠狀動脈造影中的應(yīng)用研究[J]. 實用醫(yī)院臨床雜志, 2008, 5(5): 41-43.
8. 　Cynthia MC, Dianna C, Sue E, et al. The measurement, reporting, and management of radiation dose in CT[R]. American: American Association of Physicists in Medicine, 2008. 13. (Report No. 96).
9. 　Murray CJ, Kulkami SC, Ezzati M, et al. Understanding the coronary heart disease versus total cardiovascular mortality paradox: a method to enhance the comparability of cardiovascular death statistics in the United States[J]. Circulation, 2006, 113: 2071-2081.
10. 　王錫明, 武樂斌, 李振家, 等. 64排螺旋CT冠狀動脈造影中的應(yīng)用[J]. 中華放射學(xué)雜志, 2005, 39(1): 1201-1204.
11. 　高建華, 王貴生, 李劍穎, 等. 64層螺旋CT冠狀動脈成像低劑量技術(shù)的應(yīng)用價值[J]. 臨床放射學(xué)雜志, 2008, 27(3): 388-391.
12. 　Hunold P, Vogt FM, Schmermund A, et al. Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT[J]. Radiology, 2003, 226(1): 145-152．.
13. 　WHO. Obesity: preventing and managing the global epidemic[R]. Geneva: World Health Organization, 2000. (Technical Report Series, No. 894).
14. 　陳春明, 孔靈芝. 中國成人超重與肥胖癥預(yù)防控制指南[M]. 北京: 人民衛(wèi)生出版社, 2006: 3.
  1. 1. 　Weustink AC, Mollet NR, Pugliese F, et al. Optimal electrocardiographic pulsing windows and heart rate: effect on image quality and radiation exposure at dual-source coronary CT angiography[J]. Radiology, 2008, 248(3): 792-798.
  2. 2. 　Alkadhi H, Stolzmanna P, Scheffel H, et al. Radiation dose of cardiac dual-source CT: The effect of tailoring the protocol to patient-specific parameters[J]. Eur J Radiol, 2008, 68(3): 385-391.
  3. 3. 　Schoepf UJ, Zwerner PL, Savino G, et al. Coronary CT angiography[J]. Radiology, 2007, 244(1): 48-63.
  4. 4. 　Prokop M. Radiation dose in computed tomography: risks and challenges[J]. Radiology, 2008, 48(3): 229-242.
  5. 5. 　Catalano C, Francone M. Ascareli A, et al. Optimizing radiation-dose and image quality[J]. Eur Radiol, 2007, 17(6): 26-32.
  6. 6. 　Austen WG, Edwards JE, Frey RL, et al. A reporting system on patients evaluated for coronary artery disease: report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association[J]. Circulation, 1975, 51(4): 5-40.
  7. 7. 　趙原, 蒲紅, 謝坪. 雙源CT在冠狀動脈造影中的應(yīng)用研究[J]. 實用醫(yī)院臨床雜志, 2008, 5(5): 41-43.
  8. 8. 　Cynthia MC, Dianna C, Sue E, et al. The measurement, reporting, and management of radiation dose in CT[R]. American: American Association of Physicists in Medicine, 2008. 13. (Report No. 96).
  9. 9. 　Murray CJ, Kulkami SC, Ezzati M, et al. Understanding the coronary heart disease versus total cardiovascular mortality paradox: a method to enhance the comparability of cardiovascular death statistics in the United States[J]. Circulation, 2006, 113: 2071-2081.
  10. 10. 　王錫明, 武樂斌, 李振家, 等. 64排螺旋CT冠狀動脈造影中的應(yīng)用[J]. 中華放射學(xué)雜志, 2005, 39(1): 1201-1204.
  11. 11. 　高建華, 王貴生, 李劍穎, 等. 64層螺旋CT冠狀動脈成像低劑量技術(shù)的應(yīng)用價值[J]. 臨床放射學(xué)雜志, 2008, 27(3): 388-391.
  12. 12. 　Hunold P, Vogt FM, Schmermund A, et al. Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT[J]. Radiology, 2003, 226(1): 145-152．.
  13. 13. 　WHO. Obesity: preventing and managing the global epidemic[R]. Geneva: World Health Organization, 2000. (Technical Report Series, No. 894).
  14. 14. 　陳春明, 孔靈芝. 中國成人超重與肥胖癥預(yù)防控制指南[M]. 北京: 人民衛(wèi)生出版社, 2006: 3.