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CT肺动脉成像低剂量与低对比剂用量的临床应用研究.doc

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CT肺动脉成像低剂量与低对比剂用量的临床应用研究.doc
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CT CT 60 , 30 , 90 ml, 120 kVp; 35 ml, 80 kVp CT CT (P<0.05) CT , ; CT ; ; ; ; , E-mail:yangxiaojing0716@126.com Application of CT pulmonary angiography with low dose radiation and low dosage of contrast Yang Xiaojing Zhang Chunqiu Department of Radiology, The First Hospital of Fangshan District; Abstract Objective To evaluate the feasibility of CT pulmonary angiography (CTPA) with low dose radiation and low dosage of contrast.Methods 60 patients were divided experiment and control groups.30 patients of control group underwent conventional CTPA with 120 kVp and 90 ml contrast.30 patients of experiment group underwent CTPA with 80 kVp and low contrast dosage as 30 ml.The image quality and radiation dose were analyzed between two groups.Results The image quality of the two groups met the clinical diagnostic requirements.There was no significant difference between the control group and the experimental group in the CT value of the pulmonary trunk.There were significant difference in volume CT dose index ength product groups (P<0.05) .Conclusion CT pulmonary angiography low dose radiation and low dosage of contrast can be the first choice in screening an followup for patients with pulmonary artery embolism. Keyword Pulmonary Embolism; CT pulmonary angiography; Radiation dose; Contrast medium; Image quality; (pulmonary artery embolism, PAE) , CT (CT pulmonary angiography, CTPA) [1-2], CTPA , , CTPA [3-4] (80 k Vp) CTPA 1 1.1 2015 3 ~2016 3 (PAE) 60 , 37 , 23 23~71 , 50.6 , , 60 2 , 30 , , 1.2 GE 64 CT (Discovery CT750 HD) , 120 k Vp 90 ml ( , , 370 mg I/ml) 4 ml/s; 80 k Vp 35 ml ( , , 370 mg I/ml) 3 ml/s , 250 m As, (NI) 10, 0.992, 0.4 s/r, 0.9 mm, 0.45 mm , 20 G , , 30 ml , (ROI) , 100 HU , 3 s , 1.3 ADW4.4 , (MPR) (MIP) (VRT) 2 , 4 , 4 , ;3 , 2 , ;1 , CT , CT , CT , CT SNR= / , CNR= ( - ) / 1.4 CT (CT dose index volume, CTDI vol) (Length) , (dose length product, DLP) , DLP - 1.5 SPSS 19.0 , CT ; Wilcoxon , P<0.05 2 CTPA 2.1 , , , 1 2 1 , , Figure 1 Images of small dose contrast bolus injection showed that the density of superior vena cava was lower than that of pulmonary artery, and there was no radial artifact 2 , , Figure 2 The density of the superior vena cava was high and radial artifact were observed in the conventional scan 2.2 CT CT SNR CNR : 2.3 CTDIvol (P<0.05) 3 , 20%~30%, [5] , , CT , , [6-7] , , , , [8] CT , CT 30 ml [7] 80 k V 30 ml CTPA, , , CTPA , , CT CT , [2,9] , , MCNITT CT 17%, 39%[10] CT , , , 2.8 [9,11] , , 80 k Vp 30 ml 3 ml/s CT , CT ; 42% , , , 80 k V CT , , [1] , , .64 CT [J]. , 2009, 19 (7) :832-834. [2] , , . CT [J]. , 2015, 38 (6) :557-561. [3] , , . CT [J]. , 2016, 18 (3) :324-326. [4] , , , . CT [J]. , 2014, 48 (10) :811-815. [5]Piovella F, Iosub DI.Acute pulmonary embolism:risk assessment, risk stratification and treatment options[J].The clinical respiratory journal, 2016, 10 (5) :545-554. [6]Righini M, Robert-Ebadi H, Le Gal G.Diagnosis of pulmonary embolism[J].Presse medicale, 2015, 44 (12Pt 2) :e385-391. [7]Wang RC, Bent S, Weber E, et al.The Impact of Clinical Decision Rules on Computed Tomography Use and Yield for Pulmonary Embolism:A Systematic Review and Meta-analysis[J].Annals of emergency medicine, 2016, 67 (6) :693-701, 693. [8] , , , . CT [J]. , 2015, 30 (11) :1102-1106. [9] , , , . CT [J]. , 2016, 35 (4) :626-629. [10]Mc Nitt-Gray MF.AAPM/RSNA Physics Tutorial for Residents:Topics in CT.Radiation dose in CT[J].Radiographics, 2002, 22 (6) :1541-1553. [11] . CT [J]. , 2014, 33 (12) :1935-1939.
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