胸部螺旋CT扫描的最佳造影剂浓度及延时  

Optimal Scan Delay and Concentration of Contrast in Helical CT of the Thorax

作　　者：张志勇[1] 周康荣[1] 陈刚[1] 陈惠明 陈锦 

机构地区：[1]上海医科大学中山医院放射科

出　　处：《临床放射学杂志》1997年第2期88-91,共4页Journal of Clinical Radiology

摘　　要：目的：探讨纵隔血管螺旋ＣＴ扫描的最佳延迟时间及造影剂之含碘浓度。材料与方法：本文搜集１２０例胸部螺旋ＣＴ增强扫描资料，４０例为回顾性研究组，主要研究强化血管出现伪影时的ＣＴ值，例如上腔静脉区等。另８０例为前瞻性研究组，其中又分Ｓｍａｒｔｐｒｅｐ组（研究最佳延迟时间）及造影剂浓度组（确定纵隔血管增强之最合适的造影剂浓度）。图像质量的评判标准为血管强化充分又无伪影存在。结果：头臂静脉、上腔静脉、升主动脉和肺动脉强化符合标准又无其周围伪影时其ＣＴ值分别在１９０～５３０ＨＵ，１１７～３６６ＨＵ，１１２～２５７ＨＵ及１２８～２５０ＨＵ。伪影的出现与造影剂碘浓度及延时时间密切相关，在经稀释的４种浓度中，优维显２１４ｍｇＩ／ｍｌ及２３０ｍｇＩ／ｍｌ增强效果佳而无伪影。ＧＥ螺旋ＣＴＳｍａｒｔｐｒｅｐ技术研究延迟时间表明，２０例中５例阈值达２００～３００ＨＵ，延时为４０～４５秒时，纵隔血管强化满意且无伪影。结论：本文前瞻组，纵隔血管强化好又无放射状伪影，合理的技术方案为Ｕｌｔｒａｖ－ｉｓｔ３００ｍｇＩ／ｍｌ，注射速率２ｍｌ／秒，总量８０ｍｌ，延时４５秒，或常规应用Ｓｍａｒｔｐｒｅｐ技术。我们认为降低造影剂碘浓度到２１３ｍｇＩ?Objective: The purpose of this study was to determine the optimal scan delay and concentration of contrast medium in helical CT of the mediastinal vessels.Materials and Methods:In 120 patients, 40 cases were used for retrospectively investigating the CT number of artifacts appeared on the administration route, such as superior vena cava, etc. and 80 cases were prospectively grouped as the Smartprep to study the optimal scan delay and the concentration of contrast to determine the best iodoconcentration for intravenous contrast enhancement in Spiral CT of the thorax. It was judged the image quality by vascular opacification and the presence of artifacts.Results:Attenuation values of the brachiocephalic vein, superior vena cava, ascending aorta and pulmonary artery were 190～530HU, 117～366HU, 112～257HU and 128～250HU, respectively, and without artifacts around them. The artifacts were closely correlated with the concentration contrast medium and the scan delay. Among the 4 concentrations of contrast medium (Ultravist 200mgI/ml, 214mgI/ml, 230mgI/ml and 240mgI/ml),Ultravist 214mgI/ml and 230mgI/ml exhibited the best image quality. Smartprep technique built in GE Hispeed Advantage Scanner was used in 20 cases for studing the scan delay. The results showed that, in 5 cases of this group, when the threshold was reached in 200～300HU, the delay time was 40～45 sec, and the vasculatures in mediastinum were opacified and did not exhibite the artifacts. Conclusion: A high degree of contrast enhancement of the vascular structure in mediastinum was obtained with few artifacts in our prospective group. The ideal protocal for injection of contrast material is 2ml/sec. Of Ultravist 300mgI/ml, for a total volume of 80ml. The delay between injection and scanning is 45 sec, or depends on Smartprep technique. We believe that Ultravist 213mgI/ml and 230mgI/ml are the optimal iodo concentration for intravenous contrast enhancement in spiral CT of the mediastnum.

关 键 词：造影剂 扫描延时 CT 螺旋CT 浓度 

分 类 号：R981.1[医药卫生—药品]