OBJECTIVE To compare image quality, radiation dose, and iodine intake of head-neck CT angiography (CTA) acquired by wide-detector with the gemstone spectral imaging (GSI) combination with low iodine intake or routine scan protocol. METHODS Three hundred patients who had head-neck CTA were enrolled and divided into three groups according to their BMI values: group A (18.5 kg/m2 ≦ BMI <24.9 kg/m2), group B (24.9 kg/m2 ≦ BMI <29.9 kg/m2) and group C (29.9 kg/m2 ≦ BMI ≦ 34.9 kg/m2) with 100 patients in each group. Patients in each group were randomly divided into two subgroups (n = 50) namely, A1, A2, B1, B2, C1 and C2. The patients in subgroups A1, B1 and C1 underwent GSI with low iodine intake (270 mgI/ml, 50 ml) and combined with the ASiR-V algorithm. Other patients underwent three dimensional (3D) smart mA modulation with routine iodine intake (350 mgI/ml, 60 ml). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were calculated after angiography. Images were then subjectively assessed using a 5-point scale. CT dose index of volume and dose-length product (DLP) was converted to the effective dose (ED) and then compared. RESULTS The mean CT values, SNR, CNR and subjective image quality in subgroups A2, B2 and C2 are significantly lower than in subgroups A1, B1, and C1 (P < 0.01), respectively. The ED values in subgroup A1, B1, and C1 are 55.18%, 61.89%, and 69.64% lower than those in A2, B2, and C2, respectively (P < 0.01). The total iodine intakes in subgroups A1, B1, and C1 are 35.72% lower than those in subgroups A2, B2, and C2. CONCLUSIONS The gemstone spectral imaging with monochromatic images at 53-57 keV combined with ASiR-V algorithm allows significant reduction in iodine load and radiation dose in head-neck CT angiography than those yielded in routine scan protocol. It also enhances signal intensity of head-neck CTA and maintains image quality.

中文翻译：

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使用两种带有宽探测器的扫描方案评估头颈CT血管造影术中的辐射剂量和减少碘负荷。

目的比较宽探测器与宝石光谱成像（GSI）结合低碘摄入量或常规扫描方案获得的宽幅探测器获得的头颈CT血管造影（CTA）的图像质量，辐射剂量和碘摄入量。方法纳入300例头颈CTA患者，并根据其BMI值分为三组：A组（18.5 kg / m2≤BMI <24.9 kg / m2），B组（24.9 kg / m2≤BMI <29.9） kg / m2）和C组（29.9 kg / m2≤BMI≤34.9 kg / m2），每组100名患者。每组患者被随机分为两个亚组（n = 50），分别为A1，A2，B1，B2，C1和C2。A1，B1和C1亚组的患者接受低碘摄入（270 mgI / ml，50 ml）的GSI，并与ASiR-V算法结合使用。其他患者接受了常规碘摄入量（350 mgI / ml，60 ml）的三维（3D）智能mA调制。血管造影后计算所有图像的信噪比（SNR）和对比度噪声比（CNR）。然后使用5分制主观评估图像。将体积和剂量长度乘积（DLP）的CT剂量指数转换为有效剂量（ED），然后进行比较。结果亚组A2，B2和C2的平均CT值，SNR，CNR和主观图像质量分别显着低于亚组A1，B1和C1（P <0.01）。子组A1，B1和C1中的ED值分别比A2，B2和C2中的ED值低55.18％，61.89％和69.64％（P <0.01）。子组A1，B1和C1中的总碘摄入量比子组A2，B2和C2中的碘摄入量低35.72％。结论在53-57 keV处具有单色图像的宝石光谱成像与ASiR-V算法相结合，与常规扫描方案相比，可以显着降低头颈CT血管造影术中的碘负荷和放射剂量。它还可以增强头颈CTA的信号强度并保持图像质量。