| 王 政,郑林丰,王庆国.SnapShot Assist方案和参数优化下的冠状动脉CT血管成像[J].现代生物医学进展英文版,2018,(11):2109-2113. |
| SnapShot Assist方案和参数优化下的冠状动脉CT血管成像 |
| Coronary Computed Tomographic Angiography with Optimized Protocol and Parameter by Snapshot Assist |
| Received:April 14, 2018 Revised:May 10, 2018 |
| DOI：10.13241/j.cnki.pmb.2018.11.023 |
| 中文关键词: CT 心脏冠脉成像 SnapShot Assist 软件 辐射剂量 |
| 英文关键词: X-ray computed tomography Coronary computed tomographic angiography (CCTA) SnapShot Assist software Radiation dose |
| 基金项目:上海市浦江人才计划资助(17PJ1408000) ；上海市自然科学基金资助项目(17ZR1422500)；上海交通大学医工（理）交叉基金项目资助(YG2016MS26) |
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| 中文摘要: |
| 摘要 目的：探讨运用SnapShot Assist软件不同方案和参数优化下，对冠状动脉CT血管成像（Coronary Computed Tomographic Angiography，CCTA）的图像质量和辐射剂量的影响。方法：98例患者采用SnapShot Assist进行自动分组行CCTA：A组 （n=41, eBMI<23） 80 kVp/700 mA成像，B组 （n=38, 23≤eBMI<28）100 kVp/650 mA成像 和 C组 （n=19, eBMI≥28）120 kVp/650 mA成像。每一组又分为前瞻性门控轴向扫描模式（心率≤65次/分钟）和回顾性门控螺旋扫描模式（心率＞65次/分钟）两个亚组。30例未采用SnapShot Assist软件的常规回顾性心电门控螺旋扫描模式CCTA患者为对照组。分析比较各组图像质量主观评分、对比噪声比（Contrast-to-Noise Ratio, CNR）、信噪比（Signal-to-Noise Ratio, SNR）和胸壁皮下脂肪的密度标准差（Standard Deviation，SD）、CT容积剂量指数（volume CT Dose Index, CTDIvol）和有效辐射剂量（Effective Dose，ED）。结果：（1）A、B和C组内前瞻性心电门控扫描模式图像质量主观评分均值高于回顾性心电门控扫描模式，但差异无统计学意义（P>0.05）。实验组图像质量评分与对照组无明显差异（P>0.05）。（2）与对照组相比，A、B和C组CTDIvol、ED均显著降低（P<0.05），其中辐射剂量平均下降 63 %。A、B和C组中，前瞻性心电门控轴向扫描均比回顾性心电门控螺旋扫描的CTDIvol、ED明显降低（P<0.05）。结论：SnapShot Assist对患者进行个性化方案选择下的CCTA，在不降低图像质量的同时有效减少了辐射剂量。 |
| 英文摘要: |
| ABSTRACT Objective: To study effect of different optimized protocol and parameter with SnapShot Assist on the image quality and radiation dose of coronary computed tomographic angiography (CCTA). Methods: Ninety-eight patients underwent CCTA using a GE gemstone multidetector CT system were divided automatically into three groups by SnapShot Assist software according to their eBMI: group A (n=41, eBMI <23), group B (n=38, 23 ≤ eBMI <28) and group C (n=19, eBMI ≥28). These three group were performed CCTA with parameters of 80 kVp/700 mA, 100 kVp/650 mA and 120 kVp/650mA, respectively. Each group was subdivided into prospectively electrocardiogram-gated axial scan mode (Cases' heart rate ≤65 times/minute) and retrospectively electrocardiogram-gated spiral scan mode (Cases' heart rate>65 times/min). The control group was enrolled 30 patients whom underwent CCTA with retrospectively electrocardiogram-gated spiral scan mode without SnapShot Assist. Then, we analyzed and compared subjective scores of image quality, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and standard deviation (SD) of subcutaneous fat, volume CT dose index (CTDIvol) and effective dose (ED) in different group. Results: (1) In the group A, B, and C, the subjective score of the image quality with prospectively electrocardiogram-gated axial scan mode was higher than those of the retrospectively electrocardiogram-gated spiral scan mode, respectively, but the difference was not statistically significant (P>0.05). There was no significant difference in the subjective score of the image quality between the experimental group (with SnapShot Assist) and the control group (without SnapShot Assist) (P>0.05). (2) Compared with the control group, CTDIvol and ED were significantly lower in the group A, B, and C, respectively (P<0.05), and approximate 63 % radiation dose reduction acquired by using SnapShot Assist technique. In the group A, B, and C, CTDIvol and ED of prospectively electrocardiogram-gated axial scan mode were significantly lower than those of the retrospectively electrocardiogram-gated spiral scan mode (P<0.05). Conclusion: CCTA under the personalized selection protocol with SnapShot Assist can reduce the radiation dose without effecting the image quality. |
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