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首页> 外文期刊>Acta Radiologica >Impact on image quality and radiation exposure in coronary CT angiography: 100 kVp versus 120 kVp.
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Impact on image quality and radiation exposure in coronary CT angiography: 100 kVp versus 120 kVp.

机译：冠状动脉CT血管造影术对图像质量和放射线暴露的影响：100 kVp与120 kVp。

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BACKGROUND: The risk of radiation-induced cancer has become a major concern with the increasing use of computed tomography (CT). PURPOSE: To compare image quality and radiation doses when decreasing X-ray tube peak kilovoltage (kVp) from 120 to 100 kVp in patients undergoing coronary CT angiography (CCTA). MATERIAL AND METHODS: Patients referred for evaluation of suspected coronary artery disease (CAD) underwent 64-channel detector CCTA using a tube voltage of either 120 kVp (n = 46) or 100 kVp (n = 82). The individual volume CT dose index (CTDI(vol)) and dose length product (DLP) were recorded and effective radiation dose was estimated on the basis of DLP. Subjective image quality was assessed by two radiologists on per-patient based consensus. Vascular density and image noise were quantified in the left main coronary artery (LMCA) and proximal ascending aorta (AA). Mean density in the adjacent perivascular tissue was also quantified. Contrast-to-noise ratio (CNR) was calculated. Corresponding invasive coronary angiography (ICA) was performed, which constituted the gold standard. RESULTS: Mean values in the 100/120 kVp cohorts regarding CNR in the LMCA were 12.7/16.0 (P<0.0001)) and in the AA 13.2/17.2 (P<0.0001), CTDI(vol) 34.4/57.4 mGy (a 40% reduction, P<0.0001), DLP 578/1125 mGy x cm (P<0.0001), and estimated effective dose 9.6/20.2 mSv (P<0.0001). There was no statistically significant difference in subjective image quality between the two cohorts. The sensitivity to detect significant coronary stenoses was 88% (120 kVp) and 84% (100 kVp) and the specificity was 71% (120 kVp) and 74% (100 kVp), respectively. CONCLUSION: By reduction of tube voltage from 120 to 100 kVp at CCTA, while keeping all other scanning parameters unchanged, the radiation dose to the patient can be almost halved while keeping the diagnostic image quality at a clinically acceptable level.
机译：背景：随着计算机断层扫描（CT）的日益普及，放射致癌的风险已成为主要关注的问题。目的：比较接受冠状动脉CT血管造影（CCTA）的患者的X射线管峰值千伏电压（kVp）从120 kVp降低到100 kVp时的图像质量和辐射剂量。材料和方法：被转诊以评估可疑冠状动脉疾病（CAD）的患者，使用120 kVp（n = 46）或100 kVp（n = 82）的管电压进行64通道检测器CCTA。记录个体体积CT剂量指数（CTDI（vol））和剂量长度乘积（DLP），并基于DLP估算有效放射剂量。两位放射科医生根据每个患者的共识评估了主观图像质量。在左主冠状动脉（LMCA）和近端升主动脉（AA）中量化血管密度和图像噪声。还对相邻血管周围组织中的平均密度进行了定量。计算对比度（CNR）。进行了相应的侵入性冠状动脉造影（ICA），这是金标准。结果：LMCA中100/120 kVp队列中CNR的平均值为12.7 / 16.0（P <0.0001）），AA的13.2 / 17.2（P <0.0001）中的CTDI（vol）为34.4 / 57.4 mGy（a 40减少的百分比，P <0.0001），DLP 578/1125 mGy x cm（P <0.0001），以及估计的有效剂量9.6 / 20.2 mSv（P <0.0001）。在这两个队列之间，主观图像质量没有统计学上的显着差异。检测显着冠状动脉狭窄的灵敏度分别为88％（120 kVp）和84％（100 kVp），特异性分别为71％（120 kVp）和74％（100 kVp）。结论：通过在CCTA下将灯管电压从120 kVp降低到100 kVp，同时保持所有其他扫描参数不变，可以将对患者的辐射剂量几乎减半，同时将诊断图像质量保持在临床可接受的水平。

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