CAJ | 학술논문

目的：探讨64排CT（volume CT， VCT）直接法锁骨下静脉和上腔静脉联合成像效果及其影响因素，寻求较为理想的CT直接法造影方案。方法选择锁骨下静脉和上腔静脉疾病患者34例，采用不同对比剂浓度、不同注射速率进行CT直接法锁骨下静脉和上腔静脉联合造影检查，并对图像进行对比分析，21例与X线锁骨下静脉和上腔静脉数字减影血管造影（ DSA ）进行分节段静脉显示能力对比分析。结果血流相关性伪影为影响CT锁骨下静脉和上腔静脉造影图像质量的主要因素，注射速率1.5 mL/s和2.5 mL/s组的图像评级差异有统计学意义（χ2＝5.241，P＝0.021），对比剂稀释浓度为25％与15％的图像评判差异无统计学意义（χ2＝3.526，P＝0.073）。 CT直接法锁骨下静脉和上腔静脉联合造影检查与DSA造影在右锁骨下静脉、右头臂静脉、左锁骨下静脉、左头臂静脉、上腔静脉显示能力相同（χ2＝2.078，P＝0.139），CT显示双侧锁骨下静脉的能力优于DSA造影（χ2＝8.251，P＝0.004）。结论CT显示双侧锁骨下静脉的能力优于DSA造影；采用延迟22 s经双侧肘正中静脉直接法以2.5 mL/s注射速率，52 mgI/mL浓度可获得非常满意的诊断图像。
목적：탐토64배CT（volume CT， VCT）직접법쇄골하정맥화상강정맥연합성상효과급기영향인소，심구교위이상적CT직접법조영방안。방법선택쇄골하정맥화상강정맥질병환자34례，채용불동대비제농도、불동주사속솔진행CT직접법쇄골하정맥화상강정맥연합조영검사，병대도상진행대비분석，21례여X선쇄골하정맥화상강정맥수자감영혈관조영（ DSA ）진행분절단정맥현시능력대비분석。결과혈류상관성위영위영향CT쇄골하정맥화상강정맥조영도상질량적주요인소，주사속솔1.5 mL/s화2.5 mL/s조적도상평급차이유통계학의의（χ2＝5.241，P＝0.021），대비제희석농도위25％여15％적도상평판차이무통계학의의（χ2＝3.526，P＝0.073）。 CT직접법쇄골하정맥화상강정맥연합조영검사여DSA조영재우쇄골하정맥、우두비정맥、좌쇄골하정맥、좌두비정맥、상강정맥현시능력상동（χ2＝2.078，P＝0.139），CT현시쌍측쇄골하정맥적능력우우DSA조영（χ2＝8.251，P＝0.004）。결론CT현시쌍측쇄골하정맥적능력우우DSA조영；채용연지22 s경쌍측주정중정맥직접법이2.5 mL/s주사속솔，52 mgI/mL농도가획득비상만의적진단도상。
Objective To explore the effect and influencial factors of direct method subclavian vein and superior vena cava combined imaging by 64 slice volume CT ( VCT) , and to seek the ideal scheme of direct method combined CT imaging .Methods Thirty-four patients with the subclavian vein and superior vena cava diseases were performed with direct method combined CT imaging by different contrast agent concentration and different injection rate , then the ima-ges were compared and analysed , at last, 21of 34 patients were compared segmentally with the subclavian vein and superior vena cava digital subtraction angiography ( DSA ) .Results Blood flow associated artifacts was the main influencial factors of CT angiography image quality of subclavian vein and superior vena cava , the injection rate of 1.5 mL/s and 2.5 mL/s group image rating were significant different (χ2 =5.241 , P=0.021 ) , contrast agent dilution con-centration of 25%and 15%image evaluation were not different (χ2 =3.526 , P=0.073 ) .CT direct method of subclavian vein and superior vena cava combined with angiography and DSA angiography in right subclavian vein , right brachiocephalic vein , left subclavian vein , left bra-chiocephalic vein , superior vena cava showed the same ability (χ2 =2.078 , P=0.139 ) .The images of CT in bilateral subclavian vein were better than that of DSA angiography (χ2 =8.251 , P=0.004 ) .Conclusion The images of CT in bilateral subclavian veins are better than that of DSA;The images of direct method combined CT imaging with 22 s delay , 2.5 mL/s injection rate and 52 mg/mL concentration are very satisfactory .