CAJ | 학술논문

目的探讨自然呼吸状态下高螺距双源CT肺血管造影（CTPA）技术对可疑肺栓塞患者应用的可行性、影像质量。方法对54例临床疑似肺动脉栓塞的患者（高螺距组），采用第二代双源CT行CT肺血管造影（CTPA），患者在自然呼吸下行高螺距CTPA检查（螺距为3.0，120kV，100mAs，50ml对比剂）；另选前期检查患者54例作为常规组行常规CTPA检查（螺距为0.8，120kV，100mAs，80ml对比剂），深吸气后屏气扫描。记录PA强化程度、图像噪声、信噪比、图像的整体质量、扫描范围内肺动脉分支是否存在对比剂充盈不均和心脏、呼吸运动伪影以及辐射剂量，结果进行统计学分析。结果高螺距组肺动脉主干（PT）及尖段（S1）肺动脉、后基底段（S10）肺动脉的平均 CT值为（404±104）、（453±119）和（453±119）HU，平均图像背景噪声（11±2）HU，平均检查时间为（0.67±0.09）s，平均辐射剂量为（142±31）mGy cm，明显优于常规组（P＜0.05）。检查图像无呼吸及心脏的运动伪影。肺动脉分支未见完全或部分缺损，所有患者均达到诊断要求。结论自然呼吸下状态高螺距双源CTPA检查能得到较高质量的图像，没有产生呼吸和心脏的运动伪影，且可避免出现瓦氏（Valsalva）呼吸所致的伪影。
목적탐토자연호흡상태하고라거쌍원CT폐혈관조영（CTPA）기술대가의폐전새환자응용적가행성、영상질량。방법대54례림상의사폐동맥전새적환자（고라거조），채용제이대쌍원CT행CT폐혈관조영（CTPA），환자재자연호흡하행고라거CTPA검사（라거위3.0，120kV，100mAs，50ml대비제）；령선전기검사환자54례작위상규조행상규CTPA검사（라거위0.8，120kV，100mAs，80ml대비제），심흡기후병기소묘。기록PA강화정도、도상조성、신조비、도상적정체질량、소묘범위내폐동맥분지시부존재대비제충영불균화심장、호흡운동위영이급복사제량，결과진행통계학분석。결과고라거조폐동맥주간（PT）급첨단（S1）폐동맥、후기저단（S10）폐동맥적평균 CT치위（404±104）、（453±119）화（453±119）HU，평균도상배경조성（11±2）HU，평균검사시간위（0.67±0.09）s，평균복사제량위（142±31）mGy cm，명현우우상규조（P＜0.05）。검사도상무호흡급심장적운동위영。폐동맥분지미견완전혹부분결손，소유환자균체도진단요구。결론자연호흡하상태고라거쌍원CTPA검사능득도교고질량적도상，몰유산생호흡화심장적운동위영，차가피면출현와씨（Valsalva）호흡소치적위영。
Objective To assess the feasibility and image quality of high- pitch dual- source CT pulmonary angiography (CTPA) in natural y breathing patients with suspected pulmonary embolism. Methods One hundred and eight patients with clin-ically suspected pulmonary embolism underwent CTPA examination with dual- source CT scanner. Patients were randomly divid-ed into 2 groups:patients in high- pitch group (n=54) received high- pitch CTPA (pitch 3.0, 120 kV, 100 mAs, 50ml contrast ma-terial) without special breathing requirement, patients in routine group (n=54) received normal mode CTPA (pitch 0.8, 120 kV, 100 mAs, 80ml contrast material) with inspiratory breath- hold during scanning. PA enhancement, image noise, signal to noise ratio, overal image quality, incidence of total or partial interruption of the contrast column in the PAs, and heart motion- related and breathing- related artifacts of the diaphragm and pulmonary structures were compared between two groups. Results In high- pitch group,the mean central and peripheral PA attenuation was 404 ±104 and (453 ±119) HU, mean image noise was (11±2) HU, mean examination time was (0.67±0.09)s and mean dose- length product was (142±31) mGycm, which were al better than those in routine group (P<0.05). There were no artifacts of the diaphragm or pulmonary vessels related to breathing or heart motion. There was no case of partial or total interruption of the contrast column in the PA tree. No examination was rated non- diagnostic in high- pitch group. Conclusion High- pitch dual- source CTPA in natural y breathing patients effectively pro-duces images that are free of artifacts related to breathing and cardiac motion, hence the Valsalva- related artifacts can be elimi-nated with this technique.