| BackgroundIn today's world,coronary artery disease is a cardiovascular disease with high morbidity and mortality,which seriously endangers human health and life safety.With the development of society,the incidence of coronary artery disease is rising,and the age of onset is getting lighter.Therefore,early diagnosis of coronary artery lesions helps prevent the occurrence of acute cardiovascular events.At present,coronary computed tomography angiography as a non-invasive,rapid and accurate means of imaging examination,widely used in screening and diagnosis of coronary artery disease.Clinically,combined with a variety of low radiation dose techniques for coronary artery angiography,in order to achieve low radiation dose and high image quality imaging.ObjectiveTo investigate the clinical value of low voltage,low iodine concentration contrast agent in prospective ECG-gated coronary computed tomography angiography in overweight patients.MethodsOne hundred and twenty overweight patients with suspected coronary artery disease who underwent coronary computed tomography angiography were randomly assigned into two groups,60 in each group.Group A used 100 kVp,ioversol-320mg/ml;Group B received 120 kVp,iopamidol-370mg/ml.Both groups were prospectively ECG-gated scanning.And filtered back projection reconstruction and 40% adaptive statistical iterative reconstruction were performed for group A data,group A and group A1 were obtained.Group B were filtered back projection reconstruction.The CT value,noise,signal to noise ratio and contrast to noise ratio of each group were compared and analyzed,and radiation dose,iodine intake and coronary artery segment of each group were evaluated.Results1.There was no significant difference in sex,age,body mass index and average heart rate in group A and group B(P > 0.05).2.The effective dose(1.34 + 0.38mSv)in group A was obviously lower than that in group B(2.97 + 0.51mSv),and there was a significant difference(P < 0.05).3.The iodine intake(21.27±2.58g)of the patients in group A was less than that of group B(24.54±3.01g),and there was a significant difference(P < 0.05).4.There were significant differences in CT value,noise,signal to noise ratio and contrast to noise ratio of three groups(P< 0.05).The CT values in group A1 and group A were all lower than those in group B,the noise in group A was larger,the signal to noise ratio and the contrast to noise ratio were lower,and group A1 had higher signal to noise ratio,contrast to noise ratio and lower noise.The noise in group A and A1,B two groups was statistically significant(P<0.05),but there was no significant difference between A1 and B two groups(P>0.05).There was significant difference in the contrast to noise ratio between group A and group A1,B(P<0.05),while no significant difference in the contrast to noise ratio between group A1 and group B(P>0.05).5.There was no significant difference in coronary artery segment score between the three groups(H=0.500,P=0.779).The total of assessed coronary segments among the three group was 2284.In group A1,756 coronary segments were evaluated,and 743 segments meet the diagnosis,accounting for 98.28%.In group A,748 coronary segments were evaluated,and 733 segments meet the needs,accounting for 98%.In group B,780 coronary segmenst were evaluated,and 761 segments accord with the diagnostic,accounting for 97.56%.Conclusions1.Low voltage prospective ECG-gated coronary computed tomography angiography can significantly reduce radiation dose,lower radiation damage,and decrease cancer risk.2.Iterative reconstruction can greatly reduce the image noise,improve the signal to noise ratio,the contrast to noise ratio,and improve image quality.3.Under low tube voltage conditions,low iodine concentration contrast agent of coronary computed tomography angiography can reduce the amount of contrast agent,lower iodine intake,which is beneficial to reduce the incidence of adverse reactions. |
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