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目的:对比常规前瞻性心电触发扫描及对比剂用量方案,探讨在双源CT Flash扫描模式下,低k V、低对比剂用量、手动触发扫描方案在低体重、低心率患者行冠脉CTA检查的可行性。方法:48例患者分为两组:A组:24例,体重<65kg,45次/min≤心率≤65次/min,对比剂流速和用量分别为5.0 m L/s和20 m L(350 mg I/m L),行Flash扫描,管电压采用70 k V;B组:24例,体重<65 kg,48次/min≤心率≤65次/min,对比剂流速和剂量分别为5.0 m L/s和50 m L(350 mg I/m L),行前瞻性心电触发扫描,管电压采用100k V。对原始数据进行SAFIRE迭代重建。比较两组患者的性别、年龄、心率、体重、BMI、CTDIVOL、DLP和ED,测量并比较两组图像主动脉根部、左主干、冠脉三大支近段管腔内的CT值、噪声、信噪比及主动脉根部的对比噪声比。两组冠脉图像质量采用4级评分法进行比较。结果:两组患者在性别、年龄、心率、体重、BMI及两组图像主动脉根部、左主干、冠脉三大支近段的CT值、噪声、信噪比、主动脉根部对比噪声比无显著性差异(P>0.05),在CTDIVOL、DLP和ED方面两组图像有显著性差异(P<0.05)。两组冠脉图像质量等级无显著性差异,冠脉可评价节段率均>96%。结论:双源CT在低体重、低心率患者应用70 k V超低管电压和低对比剂用量的方案进行冠状动脉CTA检查可以获得满足临床诊断的图像质量,较常规方案的放射剂量和对比剂用量显著减低。
OBJECTIVE: To compare conventional prospective electrocardiographic (ECG) -derived scan with contrast-dose regimen in patients undergoing low-mass and low-heart rate under dual-source CT Flash scan with low-k V, low contrast agent and manual triggering scan. Check the feasibility. Methods: 48 patients were divided into two groups: group A: 24 cases, body weight <65 kg, 45 times / min ≤ heart rate ≤ 65 times / min, contrast agent flow rate and dosage were 5.0 m L / s and 20 m L B group: 24 cases, body weight <65 kg, 48 times / min ≤ heart rate ≤ 65 times / min, contrast agent flow rate and dose were 5.0 m L / s and 50 m L (350 mg I / m L) underwent a prospective electrocardiographic (ICP) scan with a tube voltage of 100 kV. SAFIRE iterative reconstruction of the original data. Comparing the gender, age, heart rate, body weight, BMI, CTDIVOL, DLP and ED in two groups of patients, we measured and compared the CT values of the proximal lumen of the three branches of the aorta, , Signal to noise ratio and aortic root contrast noise ratio. The coronary angiographic quality of the two groups was compared by 4-grade score method. Results: The CT value, noise, signal-to-noise ratio, ratio of aortic root to contralateral noise in two groups of patients in gender, age, heart rate, body weight, BMI and proximal aortic root, There was no significant difference (P> 0.05). There was significant difference between the two groups in CTDIVOL, DLP and ED (P <0.05). There was no significant difference between the two groups in the quality of coronary arteries, and the rate of coronary artery evaluation was> 96%. Conclusions: Double-source computed tomography (CTA) with double-source CT in patients with low body mass and low heart rate using ultra-low voltage of 70 kV and low contrast agent can achieve satisfactory image quality in clinical diagnosis. Compared with the conventional radiation dose and contrast agent Significantly reduced consumption.