中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
31期
2186-2190
,共5页
陈彬%张文明%胡吉波%胡红杰
陳彬%張文明%鬍吉波%鬍紅傑
진빈%장문명%호길파%호홍걸
体层摄影术,X线计算机%肺栓塞%造影剂
體層攝影術,X線計算機%肺栓塞%造影劑
체층섭영술,X선계산궤%폐전새%조영제
Tomography,X-ray computed%Pulmonary embolism%Contrast media
目的 探讨第2代双源CT行CTPA的扫描方案时其增强对比剂合理使用剂量.方法 选择2011年1-6月,浙江大学医学院附属邵逸夫医院120例临床疑似肺动脉栓塞患者,行第2代双源CT-CTPA检查.患者随机分为4组,采用小剂量团注测试,双管注射对比剂及生理盐水,各组注射方案为:A组:35 ml对比剂+55 ml生理盐水,B组:40 ml对比剂+50 ml生理盐水,C组:45 ml对比剂+ 45 ml生理盐水,D组:50 ml对比剂+40 ml生理盐水.两位影像医师测量统计各目标血管增强CT值、并对图像质量及碘图伪影评分.结果 A组各段肺动脉增强CT值高于200 HU的比率( 80％ ～ 90％)低于B、C、D3组(93％ ～ 100％)(均P＜0.05),B、C、D3组间差异无统计学意义(P＞0.05)；A组图像质量评分4.33明显低于B、C、D3组(＞4.8)(均P＜0.05),B、C、D3组差异无统计学意义(P＞0.05)；A组碘图伪影评分明显高于其他3组(P＜0.05),即伪影最少,D组明显低于其他3组(P＜0.05),即碘图伪影最多,B、C组碘图伪影评分差异无统计学意义(P =0.091).结论 B、C组(40 ml对比剂+50 ml生理盐水、45 ml对比剂+45 ml生理盐水)方案图像质量好,碘图伪影少,两组差异无统计学意义.本着尽量减少对比剂使用剂量的原则,B组扫描方案较C组方案更值得临床借鉴使用.
目的 探討第2代雙源CT行CTPA的掃描方案時其增彊對比劑閤理使用劑量.方法 選擇2011年1-6月,浙江大學醫學院附屬邵逸伕醫院120例臨床疑似肺動脈栓塞患者,行第2代雙源CT-CTPA檢查.患者隨機分為4組,採用小劑量糰註測試,雙管註射對比劑及生理鹽水,各組註射方案為:A組:35 ml對比劑+55 ml生理鹽水,B組:40 ml對比劑+50 ml生理鹽水,C組:45 ml對比劑+ 45 ml生理鹽水,D組:50 ml對比劑+40 ml生理鹽水.兩位影像醫師測量統計各目標血管增彊CT值、併對圖像質量及碘圖偽影評分.結果 A組各段肺動脈增彊CT值高于200 HU的比率( 80％ ～ 90％)低于B、C、D3組(93％ ～ 100％)(均P＜0.05),B、C、D3組間差異無統計學意義(P＞0.05)；A組圖像質量評分4.33明顯低于B、C、D3組(＞4.8)(均P＜0.05),B、C、D3組差異無統計學意義(P＞0.05)；A組碘圖偽影評分明顯高于其他3組(P＜0.05),即偽影最少,D組明顯低于其他3組(P＜0.05),即碘圖偽影最多,B、C組碘圖偽影評分差異無統計學意義(P =0.091).結論 B、C組(40 ml對比劑+50 ml生理鹽水、45 ml對比劑+45 ml生理鹽水)方案圖像質量好,碘圖偽影少,兩組差異無統計學意義.本著儘量減少對比劑使用劑量的原則,B組掃描方案較C組方案更值得臨床藉鑒使用.
목적 탐토제2대쌍원CT행CTPA적소묘방안시기증강대비제합리사용제량.방법 선택2011년1-6월,절강대학의학원부속소일부의원120례림상의사폐동맥전새환자,행제2대쌍원CT-CTPA검사.환자수궤분위4조,채용소제량단주측시,쌍관주사대비제급생리염수,각조주사방안위:A조:35 ml대비제+55 ml생리염수,B조:40 ml대비제+50 ml생리염수,C조:45 ml대비제+ 45 ml생리염수,D조:50 ml대비제+40 ml생리염수.량위영상의사측량통계각목표혈관증강CT치、병대도상질량급전도위영평분.결과 A조각단폐동맥증강CT치고우200 HU적비솔( 80％ ～ 90％)저우B、C、D3조(93％ ～ 100％)(균P＜0.05),B、C、D3조간차이무통계학의의(P＞0.05)；A조도상질량평분4.33명현저우B、C、D3조(＞4.8)(균P＜0.05),B、C、D3조차이무통계학의의(P＞0.05)；A조전도위영평분명현고우기타3조(P＜0.05),즉위영최소,D조명현저우기타3조(P＜0.05),즉전도위영최다,B、C조전도위영평분차이무통계학의의(P =0.091).결론 B、C조(40 ml대비제+50 ml생리염수、45 ml대비제+45 ml생리염수)방안도상질량호,전도위영소,량조차이무통계학의의.본착진량감소대비제사용제량적원칙,B조소묘방안교C조방안경치득림상차감사용.
Objective To explore the scan protocol of second generation dual source computed tomography (CT) for CT pulmonary angiogram (CTPA) in patients with suspected pulmonary embolism and determine the proper volume of contrast medium.Methods A total of 120 patients undergoing CTPA were recruited.All examinations were performed on a second generation dual source CT.The scan delay was determined with the test bolus technique.Four contrast volume protocols were designed,namely groups A,B,C and D respectively (n =30 each).For CTPA scan of groups A,B,C and D,35,40,45 and 50 ml contrast medium were injected at an injection rate of 4 ml/s,followed by a saline chaser of 55,50,45 and 40 ml respectively.Attenuation profiles of different vascular segments ( subclavian vein,vena cava,left atrium,pulmonary trunk,S1 artery,S10 artery) were measured to evaluate the timing techniques.The image quality and artifact of iodine map were analyzed by two radiologists for comparisons.Results The percentage of pulmonary arteries exceeding optimal attenuation ( ＞ 200 HU) showed that groups of B,C and D were higher than group A (93％ - 100％ vs 80％ -90％ ).The image quality of group A was lower than the others (P ＜ 0.05) while the other groups showed no significant difference.The artifacts of iodine map of group A were much fewer than the others (P ＜ 0.05 ) and group D was much more than the other groups (P＜0.05).Groups B and C had a score of 4.13 and 3.67 respectively without significant difference (P=0.091).Conclusion With the aids of test bolus technique and proper injection protocol (40 ml contrast medium followed by 50 ml saline),the high quality image and low volume of iodine can be realized with second generation dual source CT for CTPA.
