관상동맥 전산화단층촬영 조영검사에서 생리식염수 투여를 통한 임상 유용성 평가
The Clinical Usefulness Evaluation of Normal Saline Injection in Coronary Artery Computed Tomography Angiography(Coronary CTA)
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초록
본 연구는 bolus tracking method을 이용한 관상동맥전산화단층조영검사(coronary artery CT angiography, 이하 coronary CTA)에서 조영제 주입 전 생리식염수(normal saline) 투여를 통해 변화되는 심박동수(heart rate) 특성을 고려한 촬영방법 변환으로 영상의 질과 선량에 미치는 관계를 보고자 하였다. 연구대상자는 건강검진을 목적으로 건강검진센터에 내원하여 coronary CTA을 시행한 200명의 사람을 대상으로 평가하였다. 그 결과 선량평가에서는 전향적 동조화가 후향적 동조화보다 유효선량이 6.0±1.0mSv(54.1%) 감소되었다. 평균 심박동수는 심장혈관확장제 니트로글리세린(nitroglycerin, 이하 NTG) 섭취 후 변화된 평균 심박동수와 생리식염수 투여 후 변화된 평균 심박동수 비교에서 4.8±0.3bpm의 유의한 차이의 감소를 보였고 심박동수 변화의 폭(heart rate area)에서는 평균 4.7±2.0bpm의 감소를 보였다. 영상평가에서는 SNR과 CNR, 그리고 blurring 정도의 평가에서 모두 심박동수가 감소됨에 따라 유의한 차이를 보였다. 임상에서 coronary CTA에서 피폭선량 감소와 영상의 질 향상을 위해 조영제 주입 전에 생리식염수 투여를 통한 심박동수 특성관찰이 요구된다.
Abstract
The purpose of this study is that in coronary artery angiography computed tomography (coronary CTA), to gain high quality of image and to use low dose radiation by administrating normal saline and converting the mode of scanning heart rate (HR) characteristics before infusing contrast media. All patients data (total specimens: 200, male: 108, female: 92) were measured by using appropriate mode of scanning the heart rate (HR) after injection of saline. in addition we measured radiation dose (CTDIvol, effective dose) in all examinations. CT number and noise, and blurring of coronary artery (proximal RCA, middle RCA, proximal LCA) were measured and compared. The result of this study after injection of saline, mean heart rate was decreased about 4.8±0.3bpm (beats per minute). 33 patients (13%) got converting scan mode due to reducing heart rate (HR). In prospective gating mode, radiation dose were measured less 6.0±1.0mSv (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.
참고문헌 (18)
- Coles DR, "Computed Tomography Comparison of radiation doses from multislice Computed Tomography coronary and conventional diagnostic angiography", J Am Coll Cadiol, 47, pp.1840~1845 (2006)
- Ropers D, "Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction", Circulation, 107(5), pp.664~666 (2003)
- 최연현, "Noninvasive Imaging of Atherosclerotic Plaques Using MRI and CT", Korean Circulation Journal, 35(1), pp.1~14 (2005), 대한심장학회
- Hausleiter J, "Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates", Circulation, 113, pp.1305~1310 (2006)
- Le Jemtel TH, "Diagnostic and Therapeutic Challenges in Patients with Coexistent Chronic Obstructive Pulmonary Disease and Chronic heart Failure", J Am Coll Cardiol, 49, pp.171~182 (2007)
- Hoffman U, "Image Quality vs. Heart Rate", Radiology, 234, pp.86~97 (2005)
- Staffey KS, "Clinical performance and considerations in coronary CTA", Suppl Appl Radiol, pp.33~39 (2007)
- JF Paul, "Strategies for reduction of radiation dose in cardiac multislice CT", EUR Rsdiol, 17, pp.2028~2037 (2007)
- Mollet NR, "High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional angiography", Circulation, 112, pp.2318~2323
- Poll LW, "Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation(ECG pulsing)", phantom measurements, Rofo, 174(12), pp.1500~1505 (2002)
- 강영한, "64-slice single source CT와 128-slice dual source CT를 이용한 관상동맥 조영 검사 시 환자선량 비교", 한국방사선학회논문지, 6(2), pp.129~136 (2012), 한국방사선학회[DOI]
- Ohnesorge B, "Reiser MF:Multi-slice CT in Cardiac Imaging", pp.15~59 (2002), Springer
- Leschka S, "Accuracy of MSCT coronary angiography with 64-slice technology: first ecperience,", Eur Heart J, 26, pp.1482~1487 (2005)
- Husmann L, "Feasibility of low-dose coronary CT angiography:first experience with prostpective ECGgating", Eur Heart J, 29, pp.191~197 (2008)
- Abada HT, "MDCT of the coronary arteries: feasibility of low-dose CT with ECG-pulsed tube current modulation to reduce radiation dose", AJR Am J Roentgenol, 387(390) (2006)
- Morin RL, "Radiation dose in computed tomography of the heart", Circulation, 107, pp.917~922 (2003)
- Shuman WP, "Prostpective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose.", Radiology, 248, pp.431~437 (2008)
- Earls JP, "Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique:improved image quality and reduced radiation dose", Radiology, 246, pp.742~753 (2008)