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目的探索低剂量低对比剂冠状动脉CTA个性化扫描方案的研究。方法选取2013年8月~2014年8月收治的50例前瞻性心电门控冠状动脉成像患者,依据治疗方法不同分为前瞻性扫描-CTA组(10例)及前瞻性扫描+CTA组(40例)。前瞻性扫描+CTA组使用CTA个性化扫描方案,前瞻性扫描-CTA组不采取任何方案;同时选取2014年9月~2015年9月收治的50例心电门控冠状动脉成像患者为回顾性扫描组,使用CTA个性化扫描方案。对比三种扫描方式的各种扫描参数和辐射剂量。结果三组生理盐水总量、流率和对比剂总量比较差异均无统计学意义(P>0.05);三组管电流、管电压、扫描时间和扫描范围比较差异均有统计学意义(P<0.05)。前瞻性扫描-CTA组有效辐射剂量(ED)剂量为(7.47±1.14)m Sv;剂量长度乘积(DLP)剂量为(336.47±54.84)m Gy·cm;容积剂量指数(CTDI)剂量为(24.95±1.74)m Gy;前瞻性扫描+CTA组分别为(4.95±1.45)m Sv、(261.87±64.75)m Gy·cm;、(21.67±2.47)m Gy;回顾性扫描组分别为(5.95±1.75)m Sv、(229.47±133.21)m Gy·cm、(21.75±1.95)m Gy;回顾性扫描组和前瞻性扫描+CTA组辐射剂量小于前瞻性扫描-CTA组(P<0.05)。结论 CTA个性化扫描方案联合回顾性扫描在冠状动脉患者中效果显著,其不仅可减少辐射剂量,还可为临床提供清晰的诊断图像。
Objective To explore a low dose and low contrast agent coronary CTA personalized scanning program. Methods Fifty patients with prospective ECG-gated coronary angiography from August 2013 to August 2014 were enrolled. According to the different treatment methods, they were divided into prospective CT-CTA group (n = 10) and prospective CT + CTA group 40 cases). In the prospective CT + CTA group, the CTA personalized scanning protocol was used. In the prospective scanning-CTA group, no protocol was adopted. At the same time, 50 patients undergoing ECG-gated coronary angiography between September 2014 and September 2015 were retrospectively reviewed Scan group, using CTA personalized scanning scheme. Comparing various scanning parameters and radiation doses of the three scanning methods. Results There was no significant difference in the total amount of normal saline, flow rate and contrast medium between the three groups (P> 0.05). There were significant differences in the three groups of tube current, tube voltage, scanning time and scanning range (P <0.05). In the prospective CTA group, the dose of effective radiation dose (ED) was (7.47 ± 1.14) m Sv, the dosage of DLP was (336.47 ± 54.84) m Gy · cm, and the volume dose dose (CTDI) ± 1.74) mGy, respectively. The CT scan group and CTA group were (4.95 ± 1.45) m Sv, (261.87 ± 64.75) m Gy · cm and (21.67 ± 2.47) m Gy, respectively 1.75) m Sv, (229.47 ± 133.21) m Gy · cm, (21.75 ± 1.95) m Gy, respectively. The radiation dose in the retrospective group and the prospective CT + CTA group was less than that in the prospective CTA group (P <0.05). Conclusion The CTA personalized scan combined with retrospective scan has significant effect in patients with coronary artery. It can not only reduce the radiation dose, but also provide a clear diagnostic image for the clinic.