多层螺旋CT颈动脉成像中智能触发监测点的合理选择  

Correlations of site of bolus with the image quality in multiple detector-row spiral CT angiography of carotid artery

作　　者：周建军[1] 周康荣[1] 陈祖望[1] 吴东[1] 陈惠明[1] 陈刚[1] 陈锦[1] 缪熙音[1] 刘豪[1] 陆秀良[1] 许红莲[1] 张利军[1] 

机构地区：[1]复旦大学附属中山医院放射科

出　　处：《中华放射学杂志》2005年第10期1077-1080,共4页Chinese Journal of Radiology

基　　金：卫生部博士点基金(9741)

摘　　要：目的比较4处不同智能触发监测位置对多层螺旋CT(MSCT)颈动脉成像的影响,以期获得颈动脉多层螺旋CT血管成像(MSCTA)合理的智能触发监测点。方法通过排列区分组法随机将120例分入颈总动脉、主动脉弓升部、主动脉弓降部、肺动脉主干4个监测组内,根据120条颈动脉、颈静脉的3段感兴趣区(ROI)强化情况综合评价,由2位有经验的放射科医生盲法评价,对比4组不同智能触发监测点对成像的影响。结果30例颈总动脉智能触发组中,11例触发失败,19例成功;30例主动脉弓升部智能触发组中,触发失败7例,23例成功;30例主动脉弓降部智能触发和30例肺动脉主干智能触发组全部触发成功。颈总动脉、主动脉弓升部、主动脉弓降部和肺动脉主干各组触发成功时分叉水平颈动脉强化值分别为318.1、275.8、301.2、293.9HU,邻近颈静脉的强化值分别为88.7、147.4、257.5、91.7HU;触发失败时,颈总动脉、主动脉弓升部强化值分别为279.6、247.4HU;邻近颈静脉的强化值分别为285.4、74.1HU。结论4组比较,肺动脉主干智能触发不仅成功率高,且静脉回流程度最轻,是颈动脉MSCTA的理想触发点。Objective To get an ideal bolus site by comparing the effectiveness of different bolus sites on the image quality of carotid artery MSCTA. Methods One hundred and twenty patients with or without clinical signs underwent the MSCTA examination with different bolus sites including common carotid artery, ascending aorta, descending aorta and common pulmonary artery in four groups（ 30 patients in each）, the volume data acquired was used for Maximum Intensity Projection（MIP） and Volume Rendering（VR）. General evaluation of image quality and enhancement of 120 carotid artery and jugular veins was conducted by two experienced radiological doctors. Comparative analysis was done among four groups of different bolus sites. Results Eleven of 30 cases of common carotid artery bolus and 7 of 30 of ascending aorta bolus were triggered unsuccessefully; all of 30 descending aorta and 30 common pulmonary artery bolus were triggered successfully; the carotid artery bifurcation level enhancement of common carotid artery, ascending aorta, descending aorta and common pulmonary artery triggered successfully was 318. 1 HU, 275.8 HU, 301.2 HU, and 293.9 HU, respectively, and the enhancement of jugular veins closed to the carotid artery bifurcation level was 88.7 HU, 147. d HU, 257. 5 HU, and 91.7 HU, respectively. The carotid artery bifurcation level enhancement of unsuccessful cases of the common carotid artery and the ascending aorta was 279.6 HU, 247.4 HU respectively, and the enhancement of jugular veins close to the carotid artery bifurcation level was 285. d HU, 74. 1 HU respectively. Conclusion In group Ⅰ （common carotid artery as bolus triggering sites）, there was less jugular vein circumfluence but more failure rates and limited scanning range. In group Ⅱ （ascending aorta as bolus triggering sites）, circumfluence of jugular and artifacts became obvious. In group Ⅲ（descending aorta as bolus triggering sites）, there was higher successful image but with serious veinous circumfluence. In group Ⅳ （com

关 键 词：体层摄影术 X线计算机 颈动脉 血管造影术 诊断技术和方法 多层螺旋CT血管成像 触发点 监测点 智能 合理 主动脉弓 

分 类 号：R816.2[医药卫生—放射医学]