Journal of radiological science and technology (대한방사선기술학회지:방사선기술과학)

Korean Society of Radiological Science (대한방사선과학회)
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The Clinical Usefulness Evaluation of Normal Saline Injection in Coronary Artery Computed Tomography Angiography(Coronary CTA)

관상동맥 전산화단층촬영 조영검사에서 생리식염수 투여를 통한 임상 유용성 평가

  • Jung, Kang-Kyo (Department of Radiological Science, Catholic University of DaeGu) ;
  • Lee, Mi-Hwa (Department of Radiological Science, Catholic University of DaeGu) ;
  • Cho, Pyong-Kon (Department of Radiological Science, Catholic University of DaeGu)
  • 정강교 (대구가톨릭대학교 방사선학과) ;
  • 이미화 (대구가톨릭대학교 방사선학과) ;
  • 조평곤 (대구가톨릭대학교 방사선학과)
  • Received : 2014.10.31
  • Accepted : 2014.12.05
  • Published : 2014.12.31
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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 $4.8{\pm}0.3bpm$ (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 $6.0{\pm}1.0mSv$ (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.

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 $6.0{\pm}1.0mSv$(54.1%) 감소되었다. 평균 심박동수는 심장혈관확장제 니트로글리세린(nitroglycerin, 이하 NTG) 섭취 후 변화된 평균 심박동수와 생리식염수 투여 후 변화된 평균 심박동수 비교에서 $4.8{\pm}0.3bpm$의 유의한 차이의 감소를 보였고 심박동수 변화의 폭(heart rate area)에서는 평균 $4.7{\pm}2.0bpm$의 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.

Keywords

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