Reduction of radiation dose estimates in cardiac 64-slice CT angiography in patients after coronary artery bypass graft surgery
Reduction of radiation dose estimates in cardiac 64-slice CT angiography in patients after coronary artery bypass graft surgery
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DOI：
10.1097/rli.0b013e318160b3a3
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发表时间：
2008-04-01
影响因子：
6.7
通讯作者：
Hausleiter, Joerg
中科院分区：
文献类型：
--
作者：
Hermann, Franziska;Martinoff, Stefan;Hausleiter, Joerg
目的：这项针对旁路移植手术后患者的前瞻性调查的目的是（1）估计常规旁路移植计算机断层扫描（CT）血管造影的辐射剂量，（2）研究解剖学适应和心电图控制的管电流调制对辐射剂量估计的影响，以及（3）对定性和定量图像质量参数的影响。方法：对接受 64 层 CT 血管造影（Somatom Sensation 64 Cardiac，Somatom Sensation 64 Cardiac）的 194 名连续患者估计辐射剂量。西门子医疗解决方案）。在两个连续的患者组中研究了解剖学上适应的管电流调制的影响。此外，按指示应用 ECG 控制管电流调制的影响，在两组中进行了评估。结果：64 层 CT 旁路移植研究的平均辐射剂量估计为 18.9 +/- 6.0 mSv (CTDIvol 42.3 +/- 12.9 mGy)。应用解剖学适应的管电流调制对剂量参数没有影响（CTDIvol 43.3 +/- 13.2 vs. 40.1 +/- 12.1 mGy，对于那些与没有解剖学适应的管电流调制的人相比，P = 0.1）。 ECG 控制管电流调制的额外实施导致剂量参数降低（CTDIvol 为 32.9 +/- 2.6 vs. 58.9 +/- 3.9 mGy，辐射剂量估计：14.7 +/- 1.9 mSv vs. 26.5 +/- 2.1 mSv，有 ECG 脉冲的患者与无 ECG 脉冲的患者相比，均 P < 0.01）。使用管电流调制算法不会导致图像质量恶化。结论：64 层旁路移植 CT 血管造影相关的辐射负担很大。解剖学上适应的管电流调制不会降低辐射剂量参数，而心电图控制的管电流调制与剂量估计值减少 45% 相关。两种管电流调制算法的应用并没有导致图像质量下降。
Objectives: The objectives of this prospective investigation in patients after bypass graft surgery were (1) to estimate radiation dose for routine bypass graft computed tomography (CT) angiography, (2) to study the impact of anatomically adapted and ECG-controlled tube current modulation on radiation dose estimates, and (3) effects on qualitative and quantitative image quality parameters.Methods: Radiation dose was estimated for 194 consecutive patients undergoing 64-slice CT angiography (Somatom Sensation 64 Cardiac, Siemens Medical Solutions). The impact of anatomically adapted tube current modulation was studied in 2 consecutive patients groups. Furthermore, the impact of ECG-controlled tube current modulation, applied as indicated, was evaluated in both groups.Results: Mean radiation dose estimate for a 64-slice CT bypass graft study was 18.9 +/- 6.0 mSv (CTDIvol 42.3 +/- 12.9 mGy). The application of anatomically adapted tube current modulation had no effect on dose parameters (CTDIvol 43.3 +/- 13.2 vs. 40.1 +/- 12.1 mGy for those with versus those without anatomically adapted tube current modulation, P = 0.1). Additional implementation of ECG-controlled tube current modulation resulted in reduced dose parameters (CTDIvol of 32.9 +/- 2.6 vs. 58.9 +/- 3.9 mGy and radiation dose estimates: 14.7 +/- 1.9 mSv vs. 26.5 +/- 2.1 mSv for those with versus those without ECG pulsing, both P < 0.01). There was no deterioration in image quality with use of tube current modulation algorithms.Conclusions: The radiation burden associated with 64-slice bypass graft CT angiographies is substantial. Anatomically adapted tube current modulation does not reduce radiation dose parameters, whereas ECG-controlled tube current modulation was associated with a 45% reduction in dose estimates. Application of both tube current modulation algorithms did not result in reduced image quality.