Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2017, Vol. 39 ›› Issue (1): 49-55.doi: 10.3881/j.issn.1000-503X.2017.01.009

• Orginal Article • Previous Articles     Next Articles

Optimization of kV Selection on Third-generation High-pitch Dual-source Coronary CT Angiography Using Ultra-low Contrast Media Protocols in Patients with Body Mass Index between 20-30 kg/m2 under Automatic Tube Voltage Selection

Ming WANG, Yan YI, Jian CAO, Yining WANG, Bing QI, Shuo MA, Yun WANG()   

  1. Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing100730,China
  • Received:2016-06-30 Online:2017-02-10 Published:2017-02-20
  • Supported by:
    Supported by the National Natural Sciences Foundation of China (81471725),the Beijing Municipal Natural Science Foundation (7142133),and the Health Industry Special Scientific Research Project (201402019,201402001)

Abstract:

Objective To investigate the application of automatic tube voltage selection (CARE-kV)coronary CT angiography (CCTA)using ultra-low contrast media (CM)protocols in patients with body mass index (BMI)between 20 kg/m2 and 30 kg/m2 on third-generation dual-source CT (DSCT). Methods We prospectively included 134 consecutive patients with BMI between 20 kg/m2 and 30 kg/m2who underwent CARE-kV prospective high-pitch CCTA on third-generation DSCT using the ultra-low CM protocols and divided them into two groups according to the CARE-kV results:70 kV group(n=91):65 patients with normal BMI(20 kg/m2≤BMI≤25 kg/m2)and 26 patients with high BMI(25 kg/m22);and 80 kV group(n=43):12 patients with normal BMI and 31 patients with high BMI. The 70 kV group and 80 kV group used the CM protocols of 18 ml(3.0 ml/s) and 21 ml(3.0 ml/s),respectively. The effective dose (ED),objective and subjective image quality (IQ),and results of patients in each group and subgroup were evaluated and compared.Results The ED of 70 kV group was(0.24±0.04)mSv,which was 53% lower(H=3.37,P=0.02)than that of 80 kV group [(0.51±0.05)mSv]. No significant difference of CNR and SNR had been found in normal BMI patients(H=1.81,P=0.23)and high BMI patients (H=0.91,P=0.84)among 70 kV group and 80 kV group,as well as the subjective IQ in normal BMI patients(Z=0.79,P=0.76)and high BMI patients (Z=0.77,P=0.81)among 70 kV group and 80 kV group. Conclusions When patients with BMI between 20 kg/m2 and 30 kg/m2 receive CARE-kV prospective high-pitch CCTA on third-generation DSCT,the CARE-kV results for a portion of patients may be higher than other patients with the same BMI level,so as to guarantee the equivalent IQ. The CARE-kV can help to select the patients’ optimal tube voltage value more accurately and reasonably.

Key words: third-generation dual-source CT, automatic tube voltage selection, coronary CT angiography, image quality

CLC Number: