心房颤动16层螺旋CT肺静脉造影两种增强方案对比研究  

16-detector Row CT Pulmonary Venography of Atrial Fibrillation Patients Prior to RFCA:a Study on the Effects of Two Contrast Enhancement Protocols

作　　者：单飞[1] 张志勇[1] 曾蒙苏[1] 陈刚[1] 缪熙[1] 刘豪[1] 张力军[1] 曾良斌[1] 

机构地区：[1]复旦大学附属中山医院放射科,上海200032

出　　处：《放射学实践》2007年第12期1304-1307,共4页Radiologic Practice

摘　　要：目的:探讨两种增强方案对心房颤动16层螺旋CT肺静脉造影强化效果的影响。方法:随机选择心房颤动射频消融术前16层螺旋CT肺静脉造影患者共61例,分为两组,A组35例,使用智能触发技术,总对比剂量60ml、注射流率4ml/s、监测位置为左房中部、阈值100HU;B组26例,使用固定延迟时间扫描,总对比剂量90ml、注射流率3ml/s、延迟时间25s或28s,其他扫描参数不变。扫描结束后,所有原始数据重组为1mm层厚、0.5mm层距图像后,传至工作站,采用容积成像及最大密度投影重组明确有无肺静脉变异后,在1mm层厚图像,选择两侧肺门部肺动脉、左上及右下肺静脉孔处肺静脉、左房中部任意三点,测量兴趣区CT值,计算平均值,并得出肺静脉动脉强化差值。对比两组肺动脉、肺静脉、左房强化效果及肺静脉动脉强化差值。所有统计工作由SPSS软件完成。结果:A组肺动脉强化平均值低于B组,肺静脉、左房强化平均值高于B组。结论:房颤患者射频消融术前16层螺旋CT肺静脉造影,与固定延迟时间扫描相比,采用智能触发技术可选择性显示肺静脉及左房,更有利容积成像重组。Objective：To evaluate the enhancing effects of two protocols in 16-detector row CT pulmonary venography of patients with atrial fibrillation prior to radio-frequency catheter ablation （RFCA）. Methods： 61 patients underwent 16 detector row CT pulmonary venography before RFCA,which were randomly assigned to group A （n： 35） or group B （n： 26）. Both groups were all given 300mgI/ml contrast agent. Bolus tracking was used with the monitoring location at middle left atrium and threshold 100HU,the contrast was injected at rate 4ml/s with total amount 60ml in group A. Fixed delay time was used with total amount 90ml,injection rate 3ml/s,delay time 25s or 28s （20 patients 25s,6 patients 28s） in group B. Other scanning parameters were the same in both groups. After scanning, all raw data were reconstructed into images with effective thickness lmm and interval 0.5mm,and all images were transferred into the workstation. All patients were determined whether they have variations in pulmonary venous drainage by VR and MIP images,and CT values of ROI located at bihilar pulmonary arteries, left superior and right inferior pulmonary veins in ostium and middle left atrium were measured on lmrn images. A comparison of the average CT values and the difference between pulmonary veins and arteries between two groups was made. Statistic analysis was carried out with the software of SPSS. Results： The average CT value of pulmonary arteries of group A was lower than that of group B. The average CT values of pulmonary veins and left atrium of group A were higher than those of group B. Conclusion：Compared to fixed delay time, bolus tracking protocol could selectively enhance pulmonary veins and left atrium in atrial fibrillation patients who underwent 16 detector row CT pulmonary venography before RFCA,being more beneficial for volume imaging reconstruction.

关 键 词：肺静脉 心房颤动 体层摄影术 X线计算机 对比剂 

分 类 号：R541.75[医药卫生—心血管疾病] R816.2[医药卫生—内科学]