CTUA:一次CT扫描尿路、血管一站式检查新技术初探  

A feasibility study on CT urography and angiography(CTUA) in one acquisition

作　　者：钱俨[1] 杨秀军[2] 程芙蓉[2] 唐磊华 

机构地区：[1]上海市第八人民医院干部病房,上海200235 [2]上海市第八人民医院放射科,上海200235

出　　处：《上海医学影像》2012年第4期294-298,共5页Shanghai Medical Imaging

基　　金：上海市徐汇区医学科研重点项目(No:SHXH201109);GE全球科研资助IT项目(No:VIS-11-11)

摘　　要：目的探讨应用350 mgI/mL对比剂进行4层CT一次扫描同时实现尿路与血管造影(CTUA)技术的可行性。方法选择2010年11月—2011年6月连续申请CTU检查且无明确尿路积水患者132例,先行CT平扫,间隔20 min进行2次静脉团注350 mgI/mL碘海醇100 mL,末次团注20 s后一次屏气下螺旋扫描肾上极至盆底获得CTUA源影像,5 min后相同条件再次扫描获得CTU源影像。在AW4.2工作站分别对源影像作三维容积再现重建,观察CTUA和CTU对肾、尿路、血管的显示效果,应用方差分析进行统计学处理。结果 CTUA一次扫描技术成功率为100%,对肾实质、肾盂肾盏、输尿管、膀胱、肾动脉、腹主动脉及髂动脉显示的良好率分别为99.61%、99.23%、98.46%、100%、100%、100%、96.21%,而CTU对肾实质、肾盂肾盏、输尿管、膀胱显示的良好率分别为4.63%、100%、98.84%、100%;对尿路的显示,CTUA与CTU差异无统计学意义(P>0.05),但后者无法显示肾动脉、腹主动脉及髂动脉,且难以分辨肾皮质、髓质。CTUA除与CTU一样准确显示肿瘤、结石、炎症、前列腺增生、尿路畸形外,还准确揭示肿瘤血管、动脉硬化、动脉瘤与动脉变异。结论 CTUA一站式技术可行,采用4层CT、100 mL的350 mgI/mL对比剂一次静穿、2次注射、一次扫描即可实现。Objective To assess the feasibility and a one-stop strategy of CT urography and angiography(CTUA) in one scanning acquisition using 4-MDCT with 350 mgI/ml contrast agent.Methods One hundred and thirty-two patients without evident hydronephrosis who consecutively applied for CT urography(CTU) underwent CTUA using 4-MDCT.Twice-bolus protocol consisted of 50 mL of contrast agent(350 mgI/ml) was administered immediately after urination at 2-2.5 mL/sec at 0 s and 50 mL at 3.5-4 mL/s at 20 min through the forearm venous.CTUA started with one breath-hold during 20 s after injection with 10 mm of slice thick,10 mm of interval,0.75:1 of pitch and 15 mm/rot of speed.Five minutes after injection routine CTU started using the same parameters.After thin-slice reconstruction of 5 mm thick and 2.5 mm interval,all the image data were transferred to an ADW4.2 workstation to post-process by three dimensional volume rendering(3D VR) software.The visualization of renal parenchyma,urinary tracts,and main arteries on CTUA and CTU images were reviewed and assessed.Statistical analysis was performed using variance analysis(ANOVA) to evaluate the difference,and P<0.05 was considered statistically significant.Results The technique success rate of CTUA was 100%.The good opacification on CTUA of the renal parenchyma,calix,ureter,bladder,renal artery,the aorta and iliac artery was 99.61%,99.23%,98.46%,100%,100%,100%,and 96.21%,respectively.The good opacification on CTU of the renal parenchyma,calix,ureter and bladder was 4.63%,100%,98.84%,and 100%,respectively.Urinary tracts were shown slightly better on CTU than on CTUA(P>0.05),but not any arteries and renal corticomedullary differentiation were shown clearly on CTU.Besides the tumor,stones,inflammation,prostatic hyperplasia,and deformities of urinary tracts,CTUA also accurately revealed atherosclerosis,tumor vessels,aneurysm,and arterial variations.Conclusion The one-stop CTUA is technically feasible for imaging of both CTU and CTA,achieved by using one scanning acquisition using 4-MDCT af

关 键 词：肾 解剖 肾动脉造影 尿路造影 三维成像 CT血管造影 

分 类 号：R445.3[医药卫生—影像医学与核医学]