光子计数CT“双低”扫描方案在冠状动脉CT血管成像中的应用价值

doi:10.3969/j.issn.1003-9198.2025.12.004

Abstract

Abstract: Objective To evaluate the image quality and reduction in radiation achieved by a “dual-low” protocol (low radiation dose and low contrast agent volume) using photon-counting CT (PCCT) in coronary CT angiography (CCTA). Methods Eighty patients with suspected coronary artery disease were prospectively enrolled between June and August 2024 and randomly assigned to two groups. The control group (group A, n=40) underwent CCTA with a conventional energy-integrating detector CT (EID-CT) at 100 kVp and a standard contrast agent dose (0.6 mL/kg). The experimental group (group B, n=40) was scanned using PCCT at 140 kVp with a reduced contrast agent dose (0.3 mL/kg). Radiation dose parameters, including CT does index volume (CTDIvol), dose length product(DLP), effective does(ED) and contrast agent volume, both subjective and objective image quality assessments were compared. Two radiologists independently scored image quality using a 5-point Likert scale in a blinded manner, with interobserver agreement assessed by Cohen’s Kappa. Results The ED was significantly lower in group B (3.24±1.49 mSv) than that in group A (6.64±2.93 mSv), representing a 51.2% reduction (P<0.001). The contrast agent volume was also significantly reduced in group B (25.91±7.92 mL vs 51.52±9.29 mL, P<0.001), representing a 49.7% decrease. Objective analysis revealed significantly higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aortic root and all coronary segments in group B than those in group A (all P <0.05), with CNR improvements ranging from 42% to 90%. Subjective scores showed that the rate of excellent and good image quality (4-5 points) in group B reached 95%, which was significantly higher than that in group A in terms of contrast, noise and artifacts (P<0.05). Conclusions The PCCT “dual-low” protocol for CCTA significantly reduces radiation exposure and contrast agent volume while simultaneously improving image quality.

Key words: angiocardiography, photon-counting CT, radiation dose, contrast agent, image quality

CLC Number:

ZHANG Weiting, LI Shumeng, DUAN Aobo, TANG Qian, ZHANG Jiong, HOU Ping, ZHANG Yonggao, LIU Jie. Value of photon-counting CT with a “dual-low” protocol in coronary CT angiography[J]. Practical Geriatrics, 2025, 39(12): 1207-1212.

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Value of photon-counting CT with a “dual-low” protocol in coronary CT angiography

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