Low-dose multidetector-row CT angiography of the infra-renal aorta and lower extremity vessels: image quality and diagnostic accuracy in comparison with standard DSA
Low-dose multidetector-row CT angiography of the infra-renal aorta and lower extremity vessels: image quality and diagnostic accuracy in comparison with standard DSA
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DOI：
10.1007/s00330-005-2812-z
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发表时间：
2006-01-01
影响因子：
5.9
通讯作者：
Passariello, R
中科院分区：
文献类型：
--
作者：
Fraioli, F;Catalano, C;Passariello, R
目的探讨多排螺旋CT血管造影（MDCT）中减少X线照射的可能性，并与数字减影血管造影（DSA）比较不同剂量MDCT对肾下主动脉及下肢血管的影像质量及诊断准确性。75例患者随机分为3组，每组25例，采用四排螺旋CT血管造影（4x2.5 mm）和DSA评价动脉粥样硬化疾病。MDCT扫描参数保持恒定，毫安（mAs）除外：A组：50 mAs; B组：100 mAs; C组：130 mAs。由两名血管放射科医生一致分析图像。DSA代表参考标准。对每个数据集评价MDCT的诊断价值和总辐射暴露。模拟有效剂量为男性3.7 mSv（50 mAs）、8.2 mSv（100 mAs）和13.7 mSv（130 mAs），女性4 mSv（50 mAs）、8.9 mSv（100 mAs）和14.8 mSv（130 mAs）。A组的剂量减少率为74%，B组为40%。狭窄存在和程度的评价显示，A组（50 mAs）的灵敏度、特异性、准确性、PPV和NPV分别为96%、94%、95%、83%和99%，B组（100 mAs）分别为96%、96%、96%、89%和99%，标准剂量方案C组（130 mAs）为91%和100%。因此，低剂量扫描是外周血管四排CT血管造影的一种可行且准确的选择。该技术提供了输送到患者的辐射剂量的显著减少，同时保持最佳诊断准确性。
To investigate the possibility of reducing X-ray exposure during multidetector-row spiral computed tomographic (MDCT) angiography and to compare the image quality and diagnostic accuracy of different dosages with digital subtraction angiography (DSA) in the evaluation of the infra-renal aorta and lower extremities vessels. Seventy-five patients, randomly divided into three groups of 25 patients each, were evaluated for atherosclerotic disease with four-row spiral CT angiography (4x2.5 mm) and DSA. MDCT scanning parameters were kept constant, except for milliamperage (mAs): group A: 50 mAs; group B: 100 mAs; group C: 130 mAs. Images were analysed by two vascular radiologists in consensus. DSA represented the standard of reference. The diagnostic value of MDCT and total radiation exposure were evaluated for each data set. The simulated effective dose was 3.7 mSv for 50 mAs, 8.2 mSv for 100 mAs and 13.7 mSv for 130 mAs for men, and 4 mSv for 50 mAs, 8.9 mSv for 100 mAs and 14.8 mSv for 130 mAs for women. The dose reduction was 74% for group A and 40% for group B. The evaluation of the presence and degree of stenoses revealed a sensitivity, specificity, accuracy, PPV and NPV of 96%, 94%, 95%, 83% and 99% for Group A (50 mAs), 96%, 96%, 96%, 89% and 99% for Group B (100 mAs) and 98%, 96%, 97%, 91% and 100% for the standard dose protocol, Group C (130 mAs). Low-dose scanning is thus a feasible and accurate option for four-row CT angiography of the peripheral vessels. This technique provides substantial reduction of the radiation dose delivered to the patient while maintaining optimal diagnostic accuracy.