摘要
目的探讨支气管动脉栓塞术前用低剂量支气管动脉CT造影(bronchial artery computed tomography angiography,BA-CTA)替代常规剂量BA-CTA的可行性。方法选择2020年10月至2024年2月秦皇岛市第一医院出现大量或反复咯血的96例患者的临床资料。支气管动脉栓塞术前使用256层螺旋iCT对体质量指数(body mass index,BMI)<30 kg/m2的符合纳入排除标准的90例患者进行BA-CTA扫描。采用随机数字表法将90例患者随机分为低剂量组和常规剂量组,每组45例。扫描参数:(1)低剂量组:管电压100 kVp,管电流100 mAs,造影剂50 mL;(2)常规剂量组:管电压120 kVp,自动管电流调制,造影剂80 mL。比较2组患者BA-CTA图像胸主动脉CT值、噪声、信噪比(signal to noise ratio,SNR)和对比噪声比(contrast to noise ratio,CNR),对BA-CTA主观图像质量和血管可追溯性进行评分并比较,计算有效辐射剂量,统计即刻止血率及术后1个月复发率。结果低剂量组有效辐射剂量(2.44±0.18)mSv较常规剂量组(12.00±2.13)mSv降低79.67%(P<0.05)。与常规剂量组(341.94±59.40)HU相比,低剂量组胸主动脉CT值(406.20±86.92)HU增加64.26 HU(P<0.05)。低剂量组噪声(22.80±4.95)HU高于常规剂量组(13.52±2.55)HU,SNR(18.93±6.39∶26.07±6.13)、CNR(16.52±6.03∶22.24±5.74)均低于常规剂量组(P均<0.05)。2组主观图像质量和血管可追溯性评分差异无统计学意义(P均>0.05)。2组即刻止血率均为100%。低剂量组、常规剂量组术后1个月复发率分别为4.4%、8.9%,差异无统计学意义(P=0.673)。结论对于BMI<30 kg/m2的患者,支气管动脉栓塞术前采用低剂量BA-CTA方案(100 kVp,100 mAs,50 mL造影剂)是可行的。辐射剂量减少79.67%,造影剂减少37.50%,并可满足诊断价值。
Objective To explore the feasibility of using low radiation dose bronchial artery computed tomography angiography(BA-CTA)instead of routine dose BA-CTA before bronchial artery embolization.Methods The clinical data of 96 patients with massive or recurrent hemoptysis in our hospital from October 2020 to February 2024 were selected.BA-CTA was obtained from 90 patients with a body mass index(BMI)<30 kg/m2 using a 256 multi-section iCT system before bronchial artery embolization.Ninety patients were randomly divided randomly into two groups using a random number table,with 45 patients in each group.Scanning acquisition parameters:(1)Low radiation dose group:100 kVp tube voltage,100 mAs tube current,50 mL contrast medium;(2)Routine dose group:120 kVp tube voltage,tube current was used automatic tube current modulation,80 mL contrast medium.CT attenuation of the thoracic aorta,image noise,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of BA-CTA images between the two groups of patients were compared.The subjective image quality scores and vascular traceability scores of BA-CTA images between the two groups of patients were scored and compared.The effective radiation dose in both groups were calculated.The immediate hemostasis rate of bronchial artery embolization and one month recurrence rate in both groups were calculated.Results The effective radiation dose in the low radiation dose group(2.44±0.18)mSv was reduced by 79.67%compared with the routine dose group(12.00±2.13)mSv(P<0.05).Compared with the routine dose group(341.94±59.40)HU,the low radiation dose group(406.20±86.92)HU showed an increase of approximately 64.26 HU in CT attenuation of the thoracic aorta(P<0.05).The image noise in the low radiation dose group(22.80±4.95)HU was higher than that in the routine dose group(13.52±2.55)HU.SNR(18.93±6.39 vs 26.07±6.13)and CNR(16.52±6.03 vs 22.24±5.74)in the low radiation dose group were lower than that in the routine dose group(all P<0.05).There were no statistically significant difference in subjective image quality scores and traceability scores between the two groups(all P<0.05).The immediate hemostasis rate of bronchial artery embolization was 100%in both the two groups.The recurrence rates of the low radiation group and the routine dose group at one month after BAE were 4.4%and 8.9%,respectively,with no statistically significant difference(χ^(2)=0.179,P=0.673).Conclusion For patients with BMI<30 kg/m2,BA-CTA protocol examination with low tube voltage(100 kVp),low tube current(100 mAs)combined with low contrast medium volume(50 mL)is feasible in patients with massive hemoptysis and recurrent hemoptysis,before bronchial artery embolizationwith.The radiation dose was reduced by 79.67%,the amount of contrast medium volume was reduced by 37.50%,and the diagnostic value of the images was ensured.
作者
马惠军
赵晓慧
徐蕾
何子寅
杨楠
李艾
牛洪涛
杜彪
Ma Huijun;Zhao Xiaohui;Xu Lei;He Ziyin;Yang Nan;Li Ai;Niu Hongtao;Du Biao(Radiology Teaching and Research Office,Chengde Medical University,Hebei Chengde 067000,China;Radiology Teaching and Research Office,Hebei Medical University,Hebei Shijiazhuang 050000,China;Department of Interventional Treatment,First Hospital of Qinhuangdao,Hebei Qinhuangdao 066000,China;Department of Radiology and Nuclear Medicine,The First Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,China)
出处
《中华介入放射学电子杂志》
2025年第1期23-29,共7页
Chinese Journal of Interventional Radiology:electronic edition
关键词
支气管动脉栓塞术
咯血
低剂量
CT血管造影
Bronchial artery embolisation
Hemoptysis
Low radiation dose
Computed tomography angiography
