CAJ | 학술논문

目的选择最佳的64层螺旋cT冠状动脉cT血管成像对比剂注射方案,提高临床诊断水平,进一步减少对比剂用量.方法将150例患者按数字表法随机分为以下5组:第1组为单时相组(单纯注射对比剂);第2组为双时相组(对比剂注射后继续注射生理盐水);第3、4、5组为3时相组(在注射对比剂和生理盐水注射时相间加入稀释对比剂注射时相,即同时注射对比剂和生理盐水,其比例分别为3:7、5:5和7:3).各组对比剂均采用碘海醇(350 mg I/ml),分别测量右心房、右心室、左心房、左心室、升主动脉、右冠状动脉和前降支CT值,并采用单因素方差分析(ANOVA)比较其差异;评估图像质量和上腔静脉伪影采用X2检验.结果各组间总对比剂用量分别为(67.0±5.3)、(59.9±4.9)、(62.9±3.2)、(69.2±4.57)和(70.9±4.6)ml,差异有统计学意义(F=27.43,P<0.01),第2组对比剂用量最少,其次为第3组.5组中,冠状动脉图像质量差异有统计学意义(X2=18.81,P<0.05),第1组图像质量最佳,评分为4分者22例;其次为第2组和第3组,图像质量评分≥3分者分别为26和24例.各组产生的上腔静脉伪影差异有统计学意义(X2=31.44,P<0.01),产生伪影以第1组最多(20例),第2组最少(1例).第2组右、左冠状动脉cT值均较其他组高(F值分别为2.47、4.10,P均<0.05).第3组显示右心系统最好.结论在64层冠状动脉增强扫描中,双时相和3时相注射方案优于单时相注射方案.在显示右心系统方面,3时相注射方案优于双时相注射方案.
목적 선택최가적64층라선cT관상동맥cT혈관성상대비제주사방안,제고림상진단수평,진일보감소대비제용량.방법 장150례환자안수자표법수궤분위이하5조:제1조위단시상조(단순주사대비제);제2조위쌍시상조(대비제주사후계속주사생리염수);제3、4、5조위3시상조(재주사대비제화생리염수주사시상간가입희석대비제주사시상,즉동시주사대비제화생리염수,기비례분별위3:7、5:5화7:3).각조대비제균채용전해순(350 mg I/ml),분별측량우심방、우심실、좌심방、좌심실、승주동맥、우관상동맥화전강지CT치,병채용단인소방차분석(ANOVA)비교기차이;평고도상질량화상강정맥위영채용X2검험.결과 각조간총대비제용량분별위(67.0±5.3)、(59.9±4.9)、(62.9±3.2)、(69.2±4.57)화(70.9±4.6)ml,차이유통계학의의(F=27.43,P<0.01),제2조대비제용량최소,기차위제3조.5조중,관상동맥도상질량차이유통계학의의(X2=18.81,P<0.05),제1조도상질량최가,평분위4분자22례;기차위제2조화제3조,도상질량평분≥3분자분별위26화24례.각조산생적상강정맥위영차이유통계학의의(X2=31.44,P<0.01),산생위영이제1조최다(20례),제2조최소(1례).제2조우、좌관상동맥cT치균교기타조고(F치분별위2.47、4.10,P균<0.05).제3조현시우심계통최호.결론 재64층관상동맥증강소묘중,쌍시상화3시상주사방안우우단시상주사방안.재현시우심계통방면,3시상주사방안우우쌍시상주사방안.
0bjective To determine the optimal contrast protocols for 64.slice spiral CT coronary angiography in order to reduce the volume of contrast injection.Methods One hundred fifty pailents scheduled to undergo 64-slice spiral CT coronary angiography were prospectively randomized into the following five groups with different injection protocols:group l:uniphasic injection without a flush;group 2:biphasic injection with a flush;group 3,group 4 and group 5:triphasic injection with a diluted contrast material with 3:7.5:5.7:3 contrast/saline ratio respectively.Attenuation was measured in the right atrium,right ventricle,left atrium,left ventricle,ascending aorta,fight coronary artery and left coronary artery and analyzed with single factor variance test(ANOVA).The quality the coronary artery images was evaluated and compared using person Chi-Square.Results The total contrast material vohme were (67.0±5.3)ml,(59.9±4.9)ml,(62.9±3.2)ml,(69.2 4±5.7)ml and(70.9 4-4.6)ml in five groups respectively(F=27.43,P<0.01).Image quali～scores of coronary arteries were significant different among five groups(X2=18.81,P<0.05).There were signiflcandy differences in artifacts of the superior vena cava among five groups(X2=31.44,P<0.01).The artifacts in the superior vena cava in group 1 was the most,and in group 2 was the least.The mean enhancement values of right and left coronary arteries in group 2 were significantly greater than those in other groups(F=2.47 and 4.10,P<0.05).The visualization of both left ventricle and right ventricle cavities W88 the best in group 3.Conclusion Biphasic injection and triphasic injection are better than uniphasic injection for 64-slice spiral CT coronary angiography and triphasic injecfion is better than biphasic injection for the visualization of both left ventricle and right ventricle cavities.