【摘要】 目的 探讨低管电压(80 kV)结合低浓度等渗对比剂碘克沙醇(270 mg I/mL)在640层容积CT脑灌注中的可行性。方法对临床拟行CT脑灌注检查的患者,进行随机分组:A组,管电压100 kV,对比剂320 mg I/mL碘克沙醇;B组,管电压80 kV,对比剂270 mg I/mL碘克沙醇。同时记录并计算2组的有效剂量(ED),分别选取额叶皮质、颞叶皮质、枕叶皮质、基底节区为感兴趣区(ROI),测量脑灌注参数[局部脑血容量(rCBV)、局部脑血流量(rCBF)、平均通过时间(MTT)、峰值时间(TTP)],并测量大脑中动脉M1段、颈内动脉C7段与基底动脉管腔及周围脑组织CT值,计算获得图像质量评价指标对比噪声比(CNR)和信噪比(SNR)。对2组间上述指标进行统计学分析,其中2名医师对2组图像质量评价的一致性采用Kppa分析。结果 A组的ED为7.04 mSv,B组的ED为4.56 mSv,较A组降低了35.2%,2组间的各灌注参数、CT值以及SNRCNR均无统计学意义(P>0.05),结论 低管电压80 kV联合低浓度对比剂270 mg I/mL的扫描方案可行性较好,不仅能够满足临床诊断的要求,同时减少了X线辐射剂量,降低了对比剂肾病(CIN)的发生率。更多还原

【Abstract】 Objective To evaluate the feasibility of low tube voltage(80 kV) with low concentration contrast medium iodixanol(270 mg I/mL) in cerebral perfusion using 640-slice volume CT.Methods Patients who underwent CT cerebral perfusion were randomly divided into two groups.Group A:100 kV,320 mg I/mL contrast medium;group B:80 kV,270 mg I/mL contrast medium.The effective dose(ED)was record,the frontal cortex,temporal cortex and occipital cortex were selected as regions of interest(ROI),and the cerebral perfusion parameters(rCBV,rCBF,MTT,TTP) were measured separately.The CT value of the M1 segment of cerebral middle artery,the C7 segment of internal carotid artery,the basilar artery and the surrounding brain tissue were measured.The signal-to-noise radio(SNR) and the contrast-to-noise ratio(CNR) of two groups were compared and analyzed.All data will be statistically analyzed,and the consistency of two physicians for image quality evaluation was analyzed by Kappa analysis.Results The ED of group B was 4.56 mSv,which was reduced by 35.2% compared to group A(7.04 mSv).The perfusion parameters,the CT value of ROI and the SNR,CNR for two groups were of no statistical difference(P>0.05).Conclusion The feasibility of low tube voltage combined with low concentration contrast media is better,which not only meets the requirements of clinical diagnosis,but also reduces the radiation dose and the probability of contrast induced nephropathy.更多还原