Objectives To explore the application of low-concentration iodine contrast agent in low-voltage coronary artery examination in obese patients.Methods From August 2020 to May 2021,80 obese patients with suspected coro-nary heart disease who underwent coronary computed tomography angiography(CCTA)examination were prospectively selected in Yulin First People's Hospital.The patients were grouped by random number table method,with 40 cases in each group.The high-concentration group was treated with 370 mgI/mL Uvexian,and the low-concentration group was treated with 300 mgI/mL Uvexim,and CCTA was performed for coronary artery examination with low tube voltage.The image quality,radiation dose,iodine intake and infusion rate,extravasation rate of injected contrast agent,discomfort and the occurrence of contrast-induced nephropathy were compared between the two groups.Using digital subtraction angiography(DSA)as the"gold standard"to evaluate the differential diagnostic value of low concentration iodine contrast agents for moderate and above arterial stenosis.Results There was no significant difference of image quality scores between low-concentration group and high-concentration group[(4.29±0.37)scores vs.(4.32±0.36)scores,P>0.05],and the two physicians had a high degree of consistency in evaluating image quality(P<0.05).There were no statistically significant differences in computed tomography(CT)values,contrast-to-noise ratio(CNR),signal-to-noise ratio(SNR)and figure of merit(FOM)for each coronary segment between the two groups(P>0.05).There were no statistically significant differences in volumetric CT dose index(CTDIvol),effective dose(ED)and contrast dose between the two groups(P>0.05).The total iodine dosage and iodine infusion rate in low concentration group were less than those in high concentration group,and the differences were statistically significant(P<0.05).Compared with the pre-treatment period,the renal function indexes were adjusted upward in both groups after treatment,which were lower in low concentration group than in high concentration group,and the difference was statistically significant(P<0.05).The incidences of heat and pain from con-trast injection and contrast-induced nephropathy were lower in low-concentration group than those in high-concentration group,and the differences were statistically significant(P<0.05).Using DSA examination as the"gold standard",the Kappa test showed a higher concordance between low-concentration iodine contrast and DSA in diagnosing the degree of arterial stenosis(P<0.05),and the diagnostic accuracy of low-concentration contrast for moderate and above arterial stenosis was 95.06%.Conclusions Low-concentration contrast agent can significantly reduce iodine intake and reduce the incidence of adverse reactions under the premise of ensuring image quality and accuracy in diagnosing arterial steno-sis for CCTA examination in obese patients with low tube voltage,which is worthy of clinical promotion with application.
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