rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-4-5-12rentrad-35Research ArticleСтатьиСРАВНЕНИЕ НИЗКОЙ И ВЫСОКОЙ КОНЦЕНТРАЦИИ (270 И 320 МГ ЙОДА/МЛ) ИЗООСМОЛЯРНОГО ЙОДСОДЕРЖАЩЕГО КОНТРАСТНОГО ПРЕПАРАТА ПРИ ВЫПОЛНЕНИИ МНОГОСРЕЗОВОЙ КОМПЬЮТЕРНО-ТОМОГРАФИЧЕСКОЙ КОРОНАРОГРАФИИ: ОДНОЦЕНТРОВОЕ ПРОСПЕКТИВНОЕ СЛЕПОЕ РАНДОМИЗИРОВАННОЕ ИССЛЕДОВАНИЕСOMPARISON OF LOW- AND HIGH-CONCENTRATION (270 AND 320 MG I/ML) ISO-OSMOLAR IODINATED CONTRAST MEDIA IN CORONARY CT ANGIOGRAPHY: A RANDOMIZED PROSPECTIVE SINGLE-CENTER BLINDED STUDYСиницынВ. Е.SinitsynV. E.

д. м. н., профессор, директор Центра лучевой диагностики ЛРЦ

Иваньковское шоссе, 3, Москва, 125367

MD, PhD, DSc, Professor, Director of Center of Radiology of Federal Center of Treatment and Rehabilitation

Ivan’kovskoe shosse, 3, Moscow, 125367

КомароваМ. А.KomarovaM. A.

врач-рентгенолог Центра лучевой диагностики ЛРЦ

Иваньковское шоссе, 3, Москва, 125367

Radiologist of Center of Radiology of Federal Center of Treatment and Rehabilitation

Ivan’kovskoe shosse, 3, Moscow, 125367

МершинаЕ. А.MershinaE. A.

к. м. н., заведующая отделением томографии Центра лучевой диагностики ЛРЦ

Иваньковское шоссе, 3, Москва, 125367

MD, PhD, Head of the Department of Tomography of Center of Radiology of Federal Center of Treatment and Rehabilitation 

Ivan’kovskoe shosse, 3, Moscow, 125367

elena_mershina@mail.ruФГБУ «Лечебно-реабилитационный центр» Министерства здравоохранения РФРоссияFederal Center of Treatment and Rehabilitation, Ministry of Health of the RFRussian Federation20142702201604512Copyright © Синицын В.Е., Комарова М.А., Мершина Е.А., 20162016Синицын В.Е., Комарова М.А., Мершина Е.А.Sinitsyn V.E., Komarova M.A., Mershina E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/35

Цель исследования – оценить качество изображений коронарных артерий (КА) при использовании протокола с низкой лучевой и йодной нагрузкой и обычного протокола обследования пациентов.

Материал и методы

Материал и методы. В исследование были включены 60 пациентов. Многосрезовую компьютерно-томографическую (МСКТ) коронарографию проводили на 64-спиральном компьютерном томографе в режиме проспективной электрокардиографической синхронизации, с использованием ASIR 40%. При этом 30 пациентов были обследованы с использованием йодсодержащего контрастного вещества с низкой концентрацией йода (йодиксанол, 270 мг йода/мл) при низком напряжении тока на трубке (80 кВ) (группа 1); остальные 30 пациентов – с использованием йодсодержащего контрастного вещества с высокой концентрацией йода (йодиксанол, 320 мг йода/мл) при обычном напряжении тока на трубке (120 кВ) (группа 2). Качество полученных изображений КА оценивалось субъективно по четырехбалльной шкале, изображения были рандомизированы. Рентгеновская плотность внутри просвета коронарных артерий была измерена на уровне проксимальных и дистальных сегментов передней межжелудочковой артерии (ПМЖА) и правой коронарной артерии (ПКА).

Результаты

Результаты. Возраст, частота сердечных сокращений, индекс массы тела пациентов и параметры сканирования (за исключением напряжения тока на трубке) статистически значимо не отличались по группам. Анализ полученных изображений КА не выявил достоверных отличий их качества при использовании йодиксанола-270 и йодиксанола-320 (соответственно 1,28±0,28 и 1,34±0,29, р=0,4). Не было получено статистически значимых различий измеренной плотности дистальных сегментов ПКА и ПМЖА в двух группах. Плотность, измеренная в просвете проксимальных сегментов ПКА и ПМЖА, была достоверно ниже во 2-й группе пациентов (p<0,05).

Заключение

Заключение. Проведение МСКТ-коронарографии по протоколу низкой лучевой и низкой йодной нагрузки позволяет сделать данное исследование более безопасным для пациента, не приводит к потере диагностической информации и снижению качества изображений.

Objective

Objective: to compare the image quality at coronary multidetector computed tomography (MDCT) using low-dose and lowiodine protocol study in comparison with the standard protocol.

Material and methods

Material and methods. In study included 60 patients undergoing coronary computed tomography angiography. All examinations were performed with 64-row MDCT using prospective ECG-gating and ASIR 40%. 30 patients were examined using a low-concentration (Iodixanol, 270 mg I/ml) iodinated contrast medium and low tube voltage (80 kV) (group 1), 30 patients – using of high-concentration (Iodixanol, 320 mg I/ml) iodinated contrast medium and standard tube voltage (120 kV) (group 2). Image quality of coronary arteries was evaluated using a fourpoint grading scale, images were randomised. Intra-arterial density was measured for the proximal and distal segments of left anterior descending artery (LAD) and right coronary artery (RCA).

Results

Results. Age, heart rate, BMI and scan parameters were not statistically different between the two groups. Analysis of coronaries visualization revealed the same image quality for group 1 and group 2 (image quality scores were 1,28 ± 0,28 vs. 1,34 ± 0,29, р=0,4). There was no significant difference between mean enhancement values in the distal segments of RCA and LAD for the two groups. Intraarterial density for proximal LAD and proximal RCA for the group 2 were significantly lower (p<0,05) than those values for the group 1.

Conclusion

Conclusion. The use of low-dose and low-iodine protocol can be beneficial for patient safety and for image quality without loss of diagnostic information.

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The authors declare that there are no conflicts of interest present.