CAJ | 학술논문

目的探讨320排CT低剂量血管成像在肝癌供血动脉评价中的辐射剂量及对图像质量的影响。方法将87例拟行介入治疗的肝癌患者随机分为两组，术前均以动态容积模式进行320排CT动态增强间隔时间扫描，其中研究组43例的扫描参数采用管电压100 kV，管电流75 mA，对比剂流率5 ml/s，总量50 ml，而对照组40例采用管电压120 kV，管电流100 mA，对比剂速率6 ml/s，总量70 ml；选取最佳纯肝动脉期图像进行三维重建，利用4 D-DSA成像软件测量并比较两组间的肝动脉的强化峰时间和CT值；以DSA为参照，评估两组间肝癌3、4级肝动脉供血支图像质量的优良率和可诊断率，同时比较两组间的辐射剂量。结果研究组的肝动脉达峰值和达峰绝对值均低于对照组（P＜0.05），而肝动脉达峰时间和肝动脉平扫CT值与对照组比较均无明显差异（P＞0.05）；研究组对3、4级肝动脉图像质量评价的可诊断率为97.1%、优良率89.3%，与对照组比较均无明显差异（P＞0.05）；研究组的有效辐射剂量为（15.07±2.58）mSv，明显低于对照组（P＜0.05）。结论320排CT低剂量的三维肝动脉成像，不仅图像质量能达到诊断和评价肝癌供血动脉的要求，而且能明显降低患者的辐射剂量。
목적탐토320배CT저제량혈관성상재간암공혈동맥평개중적복사제량급대도상질량적영향。방법장87례의행개입치료적간암환자수궤분위량조，술전균이동태용적모식진행320배CT동태증강간격시간소묘，기중연구조43례적소묘삼수채용관전압100 kV，관전류75 mA，대비제류솔5 ml/s，총량50 ml，이대조조40례채용관전압120 kV，관전류100 mA，대비제속솔6 ml/s，총량70 ml；선취최가순간동맥기도상진행삼유중건，이용4 D-DSA성상연건측량병비교량조간적간동맥적강화봉시간화CT치；이DSA위삼조，평고량조간간암3、4급간동맥공혈지도상질량적우량솔화가진단솔，동시비교량조간적복사제량。결과연구조적간동맥체봉치화체봉절대치균저우대조조（P＜0.05），이간동맥체봉시간화간동맥평소CT치여대조조비교균무명현차이（P＞0.05）；연구조대3、4급간동맥도상질량평개적가진단솔위97.1%、우량솔89.3%，여대조조비교균무명현차이（P＞0.05）；연구조적유효복사제량위（15.07±2.58）mSv，명현저우대조조（P＜0.05）。결론320배CT저제량적삼유간동맥성상，불부도상질량능체도진단화평개간암공혈동맥적요구，이차능명현강저환자적복사제량。
Objective To investigate the radiation dosage and image quality of low-dose 320-slice CT angiography in evaluating arterial supply of primary liver cancer.Methods 87 patients undergoing interventional therapy of liver cancer were randomly divided to low-dose(43)and control(40)groups.All patients underwent preoperative contrast-enhanced 320-slice CT angiography.The parameters were 100 kV tube voltage,75 mA tube current,and 50 mL contrast medium injection at 5 ml/s for low-dose CT;120 kV,100 mA,70 ml contrast injection at 6 mL/s for control group.The best images in the hepatic arterial phase were selected for 3D reconstruction.The peak CT values and time to peak of the hepatic arteries were determined using 4 D-DSA imaging software. Compared to digital subtraction angiography,the image quality and diagnostic rate of 3 rd and 4 th order branches of the hepatic arteries and the radiation dose were analyzed.Results The hepatic artery peak and absolute peak CT values of low-dose CT were significantly lower than that of the control(P<0.05).There was no significant difference in the time to peak and unenhanced CT values of the hepatic arteries(P>0.05).The diagnostic rate(97.1%)and rate of good image quality(89.3%)were not significantly different(P>0.05)from that of the control.The effective radiation dose of low-dose CT(15.07±2.58)was significantly(P<0.05)lower than that of control group. Conclusion Low-dose 320-slice CT angiography demonstrates well the arterial supply of liver cancer with significant reduction of radiation dose to the patients.