【摘要】 目的探讨优化胸痛三联征CT扫描方案及辐射剂量的控制。方法将2018年8月～2021年3月临床怀疑胸痛三联征的100例患者,按照管电压的不同分为对照组和观察组,每组各50例。对照组使用120KV,观察组使用100KV。采用方向回溯式心电门控扫描方式心底至主动脉弓。对比CT图像质量及操作情况;计算三幅图像的信噪比(SNR),计算对比噪声比(CNR)、辐射剂量长度乘积(DLP)和有效辐射剂量(ED)。结果观察组平均扫描时间、总检查时间、受照射剂量以及对比剂用量低于对照组,差异具有显著性(P<0.05);观察组的图像优良率98.00%(49/50),对照组86.00%(43/50),差异具有统计学意义(P<0.05);两组主动脉、肺动脉SNR无显著差异,观察组冠状动脉SNR,主动脉、肺动脉及冠状动脉的SNR均高于对照组,观察组DLP和ED均低于对照组,差异有统计学意义P <0.05。结论为保证检查胸痛三联征效果,不仅需要改变CT扫描方向,还应使用低管电压。就可达到低辐射剂量双重控制,有临床实用价值高。更多还原

【Abstract】 Objective: To optimize the CT scan plan for the chest pain triad and use a reduced tube voltage, reduce the amount of contrast agent, and reduce the radiation dose. Methods: From August 2018 to March 2021, 100 cases of clinically suspected chest pain triad were randomly divided into 120 KV control group and 100 KV observation group, using directional retrospective ECG gated scanning from the heart to the aortic arch. To evaluate the reconstructed coronary artery images, measure the CT values of the two groups of data sets of the pulmonary artery,descending aorta, right coronary artery opening, and right coronary artery starting part of the coronary artery, calculate the signal-to-noise ratio(SNR) of the three images, and calculate Contrast to noise ratio(CNR),and radiation dose length product(DLP) and effective radiation dose(ED). Results:The average scanning time, total inspection time, radiation dose and contrast agent dosage of the observation group were lower than those of the control group, The difference was significant(P<0.05); The image excellent rate of the observation group was 98.00%(49/50),the control group 86.00%(43/50), The difference was statistically significant(P<0.05); There was no significant difference in the SNR of aorta and pulmonary artery between the two groups. The SNR of coronary artery, The SNR of aorta, pulmonary artery and coronary artery of the observation group were higher than those of the control group, DLP and ED of the observation group were lower than those of the control group, The difference was statistically significant P<0.05. Conclusion: Changing the scanning direction from the bottom of the heart to the aortic arch chest pain triad scan mode, and using low tube voltage at the same time can ensure the effect of checking the triad of chest pain. It can also achieve the dual control of contrast and low radiation dose, which has more clinical practical value.更多还原