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近年来,冠状动脉CT成像(coronary computed tomography angiography,CCTA)已成为一种准确率较高的评价冠状动脉形态的无创手段[1-2],但较高的辐射剂量是限制其广泛应用的主要因素,如何在尽可能降低辐射剂量的同时又能保证图像诊断质量已成为CCTA的研究热点[3-7]。降低CCTA辐射剂量的主要方法有降低管电压、降低管电流、迭代重建技术、前瞻性大螺距扫描、精确扫描范围等。笔者就以上各方法逐一进行综述。
低辐射剂量冠状动脉成像的研究进展
The advances of low radiation dose coronary computed tomography angiography imaging
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摘要: 冠状动脉CT成像(CCTA)已成为一种准确率较高的评价冠状动脉解剖形态的无创手段,但是检查产生的高剂量辐射越来越受到人们的普遍关注。如何在尽可能降低辐射剂量的同时保证诊断质量已成为CCTA的研究热点。笔者就该方面近年的研究进展做一综述。
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关键词:
- 冠状血管 /
- 体层摄影术,X线计算机 /
- 低辐射剂量
Abstract: Coronary computed tomography angiography(CCTA) has become a noninvasive method with high accuracy for evaluation of the coronary artery morphology, meanwhile, people have been paying more attention to the high radiation dose delivered during the imaging procedure. In recent years, it has been a hot research topic of keeping the radiation dose as low as possible with no sacrifice of the imaging quality. This article summarized and explored the advances of methods in reducing radiation dose for CCTA.-
Key words:
- Coronary vessels /
- Tomography, X-ray computed /
- Low radiation dose
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[1] Alkadhi H, Stolzmann P, Desbiolles L, et al.Low-dose, 128-slice, dual-source CT coronary angiography:accuracy and radiation dose of the high-pitch and the step-and-shoot mode[J].Heart, 2010, 96(12):933-938.DOI:10.1136/hrt.2009.189100. [2] Li H, Jin D, Qiao F, et al.Relationship between the Self-Rating Anxiety Scale score and the success rate of 64-slice computed tomography coronary angiography[J].Int J Psychiatry Med, 2016, 51(1):47-55.DOI:10.1177/0091217415621265. [3] Li Q, Li P, Su Z, et al.Effect of a novel motion correction algorithm(SSF)on the image quality of coronary CTA with intermediate heart rates:segment-based and vessel-based analyses[J].Eur J Radiol, 2014, 83(11):2024-2032.DOI:10.1016/j.ejrad.2014.08.002. [4] Wang Q, Qin J, He B, et al.Computed tomography coronary angiography with a consistent dose below 2 mSv using double prospectively ECG-triggered high-pitch spiral acquisition in patients with atrial fibrillation:initial experience[J].Int J Cardiovasc Imaging, 2013, 29(6):1341-1349.DOI:10.1007/s10554-013-0203-0. [5] Ulimoen GR, Ofstad AP, Endresen K, et al.Low-dose CT coronary angiography for assessment of coronary artery disease in patients with type 2 diabetes-a cross-sectional study[J].BMC Cardiovasc Disord, 2015, 15:147-153.DOI:10.1186/s12872-015-0143-9. [6] Shen JL, Du XY, Guo DD, et al.Noise-based tube current reduction method with iterative reconstruction for reduction of radiation exposure in coronary CT angiography[J].Eur J Radiol, 2013, 82(2):349-355.DOI:10.1016/j.ejrad.2012.10.008. [7] Einstein AJ, Wolff SD, Manheimer ED, et al.Comparison of image quality and radiation dose of coronary computed tomographic angiography between conventional helical scanning and a strategy incorporating sequential scanning[J].Am J Cardiol, 2009, 104(10):1343-1350.DOI:10.1016/j.amjcard.2009.07.003. [8] Lee JW, Kim CW, Lee HC, et al.High-definition computed tomography for coronary artery stents:image quality and radiation doses for low voltage(100 kVp) and standard voltage(120 kVp) ECG-triggered scanning[J].Int J Cardiovasc Imaging, 2015, 31(Suppl 1):S39-49.DOI:10.1007/s10554-015-0686-y. [9] Labounty TM, Leipsic J, Poulter R, et al.Coronary CT angiography of patients with a normal body mass index using 80 kVp versus 100 kVp:a prospective, multicenter, multivendor randomized trial[J].AJR Am J Roentgenol, 2011, 197(5):W860-W867.DOI:10.2214/AJR.11.6787. [10] May MS, Deak P, Kuettner A, et al.Radiation dose considerations by intra-individual Monte Carlo simulations in dual source spiral coronary computed tomography angiography with electrocardiogram-triggered tube current modulation and adaptive pitch[J].Eur Radiol, 2012, 22(3):569-578.DOI:10.1007/s00330-011-2300-6. [11] Ebersberger U, Tricarico F, Schoepf UJ, et al.CT evaluation of coronary artery stents with iterative image reconstruction:improvements in image quality and potential for radiation dose reduction[J].Eur Radiol, 2013, 23(1):125-132.DOI:10.1007/s00330-012-2580-5. [12] Takx RA, Schoepf UJ, Moscariello A, et al.Coronary CT angiography:comparison of a novel iterative reconstruction with filtered back projection for reconstruction of low-dose CT-Initial experience[J].Eur J Radiol, 2013, 82(2):275-280.DOI:10.1016/j.ejrad.2012.10.021. [13] Maffei E, Martini C, Rossi A, et al.Diagnostic accuracy of second-generation dual-source computed tomography coronary angiography with iterative reconstructions:a real-world experience[J].Radiol Med, 2012, 117(5):725-738.DOI:10.1007/s11547-011-0754-x. [14] Leschka S, Stolzmann P, Desbiolles L, et al.Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses:first experience[J].Eur Radiol, 2009, 19(12):2896-2903.DOI:10.1007/s00330-009-1618-9. [15] Sun K, Han RJ, Ma LJ, et al.Prospectively electrocardiogram-gated high-pitch spiral acquisition mode dual-source CT coronary angiography in patients with high heart rates:comparison with retrospective electrocardiogram-gated spiral acquisition mode[J].Korean J Radiol, 2012, 13(6):684-693.DOI:10.3348/kjr.2012.13.6.684. [16] Wolf F, Leschka S, Loewe C, et al.Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom:comparison with the sequential and low-pitch spiral mode[J].Eur Radiol, 2010, 20(9):2084-2091.DOI:10.1007/s00330-010-1792-9. [17] Sun K, Li K, Han R, et al.Evaluation of high-pitch dual-source CT angiography for evaluation of coronary and carotid-cerebrovascular arteries[J].Eur J Radiol, 2015, 84(3):398-406.DOI:10.1016/j.ejrad.2014.11.009. [18] Gordic S, Husarik DB, Desbiolles L, et al.High-pitch coronary CT angiography with third Generation dual-source CT:limits of heart rate[J].Int J Cardiovasc Imaging, 2014, 30(6):1173-1179.DOI:10.1007/s10554-014-0445-5. [19] Zimmermann E, Dewey M.Whole-heart 320-row computed tomography:reduction of radiation dose via prior coronary Calcium scanning[J].RoFo, 2011, 183(1):54-59.DOI:10.1055/s-0029-1245629. [20] Formosa A, Santos DM, Marcuzzi D, et al.Low contrast dose catheter-directed CT angiography(CCTA)[J].Cardiovasc Intervent Radiol, 2016, 39(4):606-610.DOI:10.1007/s00270-015-1232-y. [21] Yin WH, Lu B, Gao JB, et al.Effect of reduced x-ray tube voltage, low Iodine concentration contrast medium, and sinogram-affirmed iterative reconstruction on image quality and radiation dose at coronary CT angiography:results of the prospective multicenter REALISE trial[J].J Cardiovasc Comput Tomogr, 2015, 9(3):215-224.DOI:10.1016/j.jcct.2015.01.010. [22] Komatsu S, Kamata T, Imai A, et al.Coronary computed tomography angiography using ultra-low-dose contrast media:radiation dose and image quality[J].Int J Cardiovasc Imaging, 2013, 29(6):1335-1340.DOI:10.1007/s10554-013-0201-2.
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