肝硬化患者门静脉期图像:对比剂剂量及扫描时间的影响  

Portal Venous Phase Images in Patients With Liver Cirrhosis:Effects of Contrast Agent Dose and Scanning Time

作　　者：杨华[1] 邹利光[1] 马琼英[1] 刘云[1] 姜纯蓉[1] 孙清荣[1] 王智平[1] 杨春艳[1] 

机构地区：[1]第三军医大学新桥医院放射科,重庆400037

出　　处：《临床放射学杂志》2010年第9期1249-1252,共4页Journal of Clinical Radiology

摘　　要：目的探讨对比剂剂量及扫描时间对肝硬化患者门静脉期图像质量的影响。资料与方法 60例临床确诊的肝硬化患者随机分为3组:常规剂量常规扫描组(A)、大剂量常规扫描组(B)和大剂量延迟扫描组(C),每组20例;20例年龄相匹配的非肝硬化患者作为对照组。A组、对照组对比剂剂量1.5 ml/kg体重,B组、C组剂量为2.5 ml/kg体重,注射流率均为3.5 ml/s,A、B组及对照组门静脉期扫描时间为60 s,C组门静脉期扫描时间为70 s。测量门静脉、肝实质及肝静脉的CT值,并对图像质量进行双盲目测评分。结果 A、B、C组及对照组门静脉CT值分别为(142.16±15.25)HU、(168.29±14.63)HU、(151.42±11.96)HU和(187.73±9.45)HU;肝实质CT值分别为(87.91±11.16)HU、(98.75±10.86)HU、(93.43±11.48)HU和(109.20±5.79)HU;肝静脉CT值分别为(121.09±16.78)HU、(130.54±15.31)HU、(136.92±17.53)HU和(160.55±14.27)HU。肝硬化组门静脉、肝实质、肝静脉CT值及门静脉、肝静脉与肝实质之间的CT值差值均低于对照组(P<0.05),B组门静脉密度高于A组和C组(P<0.05),B组肝实质密度较A组和C组增高,但和C组间差别没有显著性(P>0.05)。C组相对于A组肝静脉CT值显著增加,同时肝实质密度轻度降低,两者差值明显提高(P<0.05),C组图像质量评分高于A组及B组(P<0.05)。结论肝硬化患者多期增强扫描应增大对比剂剂量,门静脉期扫描时间应适当延迟。Objective To explore the effects of contrast agent dose and scanning time on portal venous phase image quality in patients with liver cirrhosis.Materials and Methods Sixty patients with liver cirrhosis were randomly divided into three groups：A,B and C,with 20 patients in each group.20 age-matched patients without liver cirrhosis were selected as control group.Iodine contrast agents were used with injection rate of 3.5 ml/s.The doses of contrast agent were 1.5 ml/kg in group A and control,2.5 ml/kg in group B and C.Scan delay time in group C was 70s,and 60s in the other groups.The CT values of portal vein,liver parenchyma and hepatic vein were measured.The image quality was scored with double-blind method.Results The CT values of portal vein,liver parenchyma and hepatic vein were（142.16±15.25）HU,（87.91± 11.16） HU and（121.09±16.78）HU in group A,（168.29±14.63）HU,（98.75±10.86）HU,（130.54±15.31）HU in group B,（151.42±11.96）HU,（93.43±11.48）HU,（136.92±17.53）HU in group C,and（187.73±9.45）HU,（109.20±5.79）,（160.55±14.27）HU in control respectively.The CT value in group A was significantly lower than that in control group（P0.05）.The CT values of portal vein in group B were significantly higher than that in group A and C（P0.05）.The CT values of hepatic vein in group C were significantly higher than that in group A（P0.05）.The image quality scores in group C were higher than that in group A and B（P0.05）.Conclusion Contrast agent dose should be increased at multi-phase enhanced scanning in patients with cirrhosis,and portal venous phase should be appropriately delayed.

关 键 词：体层摄影术 X线计算机 肝硬化 图像质量 

分 类 号：R575.2[医药卫生—消化系统]