中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
12期
1207-1210
,共4页
刘杰%高剑波%郭华%张永高%董雷钢%王超琴
劉傑%高劍波%郭華%張永高%董雷鋼%王超琴
류걸%고검파%곽화%장영고%동뢰강%왕초금
造影剂%体层摄影术%X线计算机%对比研究
造影劑%體層攝影術%X線計算機%對比研究
조영제%체층섭영술%X선계산궤%대비연구
Contrast media%Tomography%X-ray computed%Comparative study
目的 探讨腹主动脉CTA低剂量对比剂成像的可行性.方法 将98例行腹主动脉CTA检查的患者按照对比剂剂量和注射流率的不同随机分为3组,均采用碘海醇(350 mgI/ml),A组34例,对比剂用量为90ml,生理盐水20ml,注射流率4 ml/s;另外64例对比剂剂量和流率按照公式注射流率=患者体质量×对比剂剂量和体质量的比值/(5+曝光扫描时间)计算获得,每组32例,B组和C组对比剂剂量和体质量的比值分别为0.8～0.9和0.6～0.7 ml/kg.根据原始图像和MIP像评价腹主动脉及其分支、肾动脉及其分支图像质量,并测量血管内的对比剂浓度,采用单因素方差分析比较各组腹主动脉及其分支的CT值,采用x2检验比较肾动脉及其分支的评分.结果 3组中腹主动脉、腹腔干、肾动脉、脾动脉和肠系膜上动脉均清晰显示,3组腹主动脉内CT值分别为(363 ±28)、(362 ±28)和(334±14) HU,腹腔干内CT值分别为(368±28)、(367±28)和(338±15)HU,肾动脉内CT值分别为(365±27)、(364 ±29)和(336±15) HU,脾动脉内CT值分别为(373±28)、(372 ±28)和(343±15)HU,肠系膜上动脉内CT值分别为(374±28)、(372±28)和(344±16)HU,3组间上述血管内CT值差异均有统计学意义(P值均为0.000),两两比较,A组和C组、B组和C组间各血管内CT值差异有统计学意义(P值均＜0.01),A组和B组间各血管内CT值差异无统计学意义(P值均＞0.05).A组每例患者对比剂用量为90ml,B组和C组每例患者人均对比剂用量分别为(51±9)和(40±9)ml,差异有统计学意义(F=537.091,P=0.000),两两比较差异均有统计学意义(P=0.000).A组肾动脉图像质量优秀、良好和一般的为26、7和1例,B组分别为24、7和1例,C组分别为22、8和2例,差异无统计学意义(x2 =0.561,P=0.755).结论 腹主动脉CT血管成像个体化注射方式在满足临床诊断的需要下最大程度的减少了对比剂的用量.
目的 探討腹主動脈CTA低劑量對比劑成像的可行性.方法 將98例行腹主動脈CTA檢查的患者按照對比劑劑量和註射流率的不同隨機分為3組,均採用碘海醇(350 mgI/ml),A組34例,對比劑用量為90ml,生理鹽水20ml,註射流率4 ml/s;另外64例對比劑劑量和流率按照公式註射流率=患者體質量×對比劑劑量和體質量的比值/(5+曝光掃描時間)計算穫得,每組32例,B組和C組對比劑劑量和體質量的比值分彆為0.8～0.9和0.6～0.7 ml/kg.根據原始圖像和MIP像評價腹主動脈及其分支、腎動脈及其分支圖像質量,併測量血管內的對比劑濃度,採用單因素方差分析比較各組腹主動脈及其分支的CT值,採用x2檢驗比較腎動脈及其分支的評分.結果 3組中腹主動脈、腹腔榦、腎動脈、脾動脈和腸繫膜上動脈均清晰顯示,3組腹主動脈內CT值分彆為(363 ±28)、(362 ±28)和(334±14) HU,腹腔榦內CT值分彆為(368±28)、(367±28)和(338±15)HU,腎動脈內CT值分彆為(365±27)、(364 ±29)和(336±15) HU,脾動脈內CT值分彆為(373±28)、(372 ±28)和(343±15)HU,腸繫膜上動脈內CT值分彆為(374±28)、(372±28)和(344±16)HU,3組間上述血管內CT值差異均有統計學意義(P值均為0.000),兩兩比較,A組和C組、B組和C組間各血管內CT值差異有統計學意義(P值均＜0.01),A組和B組間各血管內CT值差異無統計學意義(P值均＞0.05).A組每例患者對比劑用量為90ml,B組和C組每例患者人均對比劑用量分彆為(51±9)和(40±9)ml,差異有統計學意義(F=537.091,P=0.000),兩兩比較差異均有統計學意義(P=0.000).A組腎動脈圖像質量優秀、良好和一般的為26、7和1例,B組分彆為24、7和1例,C組分彆為22、8和2例,差異無統計學意義(x2 =0.561,P=0.755).結論 腹主動脈CT血管成像箇體化註射方式在滿足臨床診斷的需要下最大程度的減少瞭對比劑的用量.
목적 탐토복주동맥CTA저제량대비제성상적가행성.방법 장98례행복주동맥CTA검사적환자안조대비제제량화주사류솔적불동수궤분위3조,균채용전해순(350 mgI/ml),A조34례,대비제용량위90ml,생리염수20ml,주사류솔4 ml/s;령외64례대비제제량화류솔안조공식주사류솔=환자체질량×대비제제량화체질량적비치/(5+폭광소묘시간)계산획득,매조32례,B조화C조대비제제량화체질량적비치분별위0.8～0.9화0.6～0.7 ml/kg.근거원시도상화MIP상평개복주동맥급기분지、신동맥급기분지도상질량,병측량혈관내적대비제농도,채용단인소방차분석비교각조복주동맥급기분지적CT치,채용x2검험비교신동맥급기분지적평분.결과 3조중복주동맥、복강간、신동맥、비동맥화장계막상동맥균청석현시,3조복주동맥내CT치분별위(363 ±28)、(362 ±28)화(334±14) HU,복강간내CT치분별위(368±28)、(367±28)화(338±15)HU,신동맥내CT치분별위(365±27)、(364 ±29)화(336±15) HU,비동맥내CT치분별위(373±28)、(372 ±28)화(343±15)HU,장계막상동맥내CT치분별위(374±28)、(372±28)화(344±16)HU,3조간상술혈관내CT치차이균유통계학의의(P치균위0.000),량량비교,A조화C조、B조화C조간각혈관내CT치차이유통계학의의(P치균＜0.01),A조화B조간각혈관내CT치차이무통계학의의(P치균＞0.05).A조매례환자대비제용량위90ml,B조화C조매례환자인균대비제용량분별위(51±9)화(40±9)ml,차이유통계학의의(F=537.091,P=0.000),량량비교차이균유통계학의의(P=0.000).A조신동맥도상질량우수、량호화일반적위26、7화1례,B조분별위24、7화1례,C조분별위22、8화2례,차이무통계학의의(x2 =0.561,P=0.755).결론 복주동맥CT혈관성상개체화주사방식재만족림상진단적수요하최대정도적감소료대비제적용량.
Objective To study the feasibility of abdominal aortic CT angiography with low dose contrast medium.Methods The patients who took the examinations were divided into three groups.In 34 patients of group A,the injection flow rate was 4 ml/s,and the contrast medium volume was 90 ml and 20 ml of saline was applied.The contrast medium dose and injection flow rate of the other 64 patients were determined according to the formula,injection tlow rate = patients' body mass × ratio of contrast medium dose to the body mass / (5 + exposure time).In B and C group with 32 cases each,the ratio of contrast medium dose to body mass were 0.8 to 0.9 and 0.6 to 0.7 ml/kg.The depiction and the measured intraarterial concentration of contrast medium of the abdominal aorta and the renal arteries as well as their branches were compared and evaluated on the source images and MIP images generated among three groups respectively.CT values of the abdominal aorta and its branches in each group were analyzed using singlefactor analysis of variance,while renal artery and its branches were analyzed using x2 test score.Results The abdominal aorta,the celiac trunk,the splenic artery,the superior mesenteric artery,the renal arteries and their branches were all well shown in three groups.The CT value within the abdominal aorta were (363 ±28),(362 ±28) and (334 ± 14) HU for the three groups respectively,the CT values within the celiac were (368 ±28),(367 ±28) and (338 ± 15)HU,the CT value within the renal artery were (365 ±27),(364 ± 29) and (336 ± 15) HU respectively,the CT value within the splenic artery were (373 ±28),(372 ± 28) and (343 ± 15) HU respectively,and the CT value within the superior mesenteric artery were ( 374 ± 28 ),( 372 ± 28 ) and ( 344 ± 16 ) HU respectively.There were significant differences among the three groups ( P = 0.000).There were significant differences between A group and C group,B group and C group ( P ＜ 0.01 ),while no significant difference existed between A group and B group( P ＞0.05 ).The amount of contrast agent for each patient in group A was 90 ml,while the amount of contrast agent in group B and C was (51 ± 9) and (40 ± 9) ml respectively.There were significant differences of the contrast medium volume among the three groups ( F = 537.091,P = 0.000).Results of pairwise comparisons were statistically significant(P =0.000).Image quality of renal artery in group A was rated as excellent,good,and generally for 26,7 and 1 cases,24,7 and 1 for group B,and 22,8 and 2 for group C.There were no significant differences in image quality of the renal arteries among the three groups ( x2 = 0.561,P = 0.755 ).Conclusion The individualization of injection method in abdominal aortic CT angiography can minimize the amount of contrast agent but to meet the clinical requirements.
