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KMID : 1149020170190020049
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Journal of Korean Society of Computed Tomographic Technology
2017 Volume.19 No. 2 p.49 ~ p.58
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A Study on the Total Amount of Contrast Media and the Flowing Rate Reduction in the Lower Extremity CTA Using Spectral CT
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Son Ji-Hoon
Shim Kyu-Seop
Lee Myung-Uk
Kim Eui-Tae
Kim Dong-Yung
Ji Won
Kang Eun-Sung
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Abstract
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Purpose : The purpose of this study is to minimize the capacity dependent side effect occurring
in the patients by reducing the contrast media injection quantity and the flow rate during the lower extremity CTA test using Spectral CT, and to find proper mono energy level to judge its clinical value.
Materials and Methods : It was conducted targeting 20 patients who had Lower extremity CTA test from June 1st, 2016 to October 31st, 2016 by means of the equipment IQon Spectral CT from PHILIPS. They were divided into the control group - Routine contrast volume group (10 persons, contrast media of 150 ml, saline of 50 ml, and flowing rate of 5 ml/second) and the experimental group ? Low contrast volume group (10 persons, contrast media of 50 ml, saline of 50 ml, and flowing rate of 3 ml/second) for comparison. In particular, the experimental group was subdivided into the 40, 45, 50, 55, 60, 65, and 70 keV data by means of the Spectral based imagd (SBI) data ? mono energy level from patient. The average of Mean HU, STD, SNR, and CNR was quantitatively analyzed by setting the region of interest (ROI) of the image. 3D reconstruction image was evaluated by 5 - score criterion for the qualitative analysis.
Results : The mean HU of the contrast group and the experimental group appeared as 461.2 ± 23.10 HU, 168.80 ± 6.05 HU each, especially mean 450.46 ± 12.37 HU appeared in 40 keV, which was about 97.67 % compared with the contrast group. SNR and CNR appeared as 34.69 ± 4.76, 29.83 ± 3.88 in 40 keV, which were about 157.1 %, 154.7 % compared to the contrast group. They appeared as the similar result value to the contrast group in 50~55 keV. Also, they all showed the statistically significant difference. The evaluation score of the 3D reconstruction image was 4.8 ± 0.42 and 4.4 ± 0.51 each in the control group and experimental group (40 keV). There was no diagnostic difference and the best score appeared in 40 keV.
Conclusion : The diagnostic difference of the Lower extremity CTA test which reduced the contrast media injection quantity and the scanning speed by using SBI data was not big compared to the existing test, and showed the optimal image quality in 40 keV. It is thought to be useful for the patients that who application of contrast media is seriously considered due to the degeneration of kidney function or for the aged patients that securing 18G line is difficult. In particular, it is highly recommended because it reduces the risk of the angiodynia or extravasation and reduces the burden of kidney on the contrast media, and all of the patients, medical teams, and testers are satisfied.
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KEYWORD
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Spectral, SBI
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