按患者体重分期注射造影剂方案在64层螺旋CT冠状动脉成像中的应用  

Application of staging injection protocol of contrast medium designed by patient's body weight in 64-slice spiral CT coronary angiography

作　　者：杜国忠[1] 黄裕宏 

机构地区：[1]江苏省扬中市人民医院影像科,江苏扬中212200

出　　处：《实用医学影像杂志》2011年第5期278-281,共4页Journal of Practical Medical Imaging

基　　金：镇江市科研基金项目:项目编号F22010012

摘　　要：目的评价按患者体重设计的分期注射造影剂方案在64层螺旋CT冠状动脉成像(MSCTCA)中的应用,并与传统注射法比较。方法 100例拟接受MSCTCA患者随机分为传统注射组(共50例,先注射造影剂85 mL,后注射生理盐水30 mL)和分期注射组(50例)。分期注射组按患者体重(<60,61～74,>75 kg)又分为3个亚组。3亚组患者均接受3期注射:1期,均注射生理盐水16 mL;2期,分别注射造影剂70,75和80 mL;3期,分别注射造影剂与生理盐水(3∶7)混合物30,30和40 mL。由两名经验丰富的放射医师盲法评价冠状动脉各分支(15节段)显示情况与图像质量,并比较两种注射方案的差异。结果分期注射组中右冠状动脉(RCA)远段、右后降支(RPD)、左前降支(LAD)远段、第一第二对角支(D1、D2)、左回旋支(LCX)远段、左室后支(LVP)及左后降支(LPD)的图像质量明显优于传统注射组(P<0.05),但是两组间RCA近段、RCA中段、左主干(LM)、LAD近段与中段、LCX近段及钝缘支(BE)的图像质量无明显差异(P>0.05)。结论在MSCTCA中,分期注射方案较传统注射法明显提高了冠脉动脉远端分支的强化程度,提供了更好的图像质量,因而能更好地满足临床诊断要求。Objective To evaluate the utility of staging injection protocol of contrast medium designed by patient＇s body weight in 64-slice spiral CT coronary angiography（MSCTCA） and to compare with that of traditional injection modality.Methods A hundred patients who will undergo MSCTCA were randomly divided into two groups which comprised traditional injection group（n=50） and staging injection group（n=50）.The former was initially injected by 85 mL of contrast medium（0mnipaque） and then 30 mL of saline,while the latter was based on patient＇s different body weight（60,61-74,75 kg） and divided into three subgroups.Three subgroup patients underwent following three stage injections： stage 1,all were injected by 16 mL of saline;stage 2,injected by 70,75 and 80 mL of contrat medium,respectively;stage 3,injected by 30,30 and 40 mL of contrast medium and saline（3∶7） mixture,respectively.The visualization state and imaging quality of the coronary artery branches（15 segments） were evaluated by two experienced radiologists using a double-blind method,simultaneously,the difference between both groups was compared.Results Imaging quality of distal segments of right coronary artery（RCA）,right posterior descending（RPD）,distal segments of left anterior descending（LAD）,first diagonal branch（D1）,second diagonal branch（D2）,distal segments of left circumflex（LCX）,left ventricular posterior branch（LVP）,and left posterior descending（LPD） in staging injection group was significantly superior to that in traditional injection group（P〈0.05） but the imaging quality of proximal-middle segment of RCA,left main（LM）,proximal-middle segments of LAD,proximal segment of LCX and blunt edge branch between both groups was not significant difference（P〈0.05）.Conclusion During MSCTCA,staging injection protocol in comparising with traditional injection modality significantly elevated the visualization of distal coronary artery branches and provided better imaging quality,so that it

关 键 词：64层螺旋CT 冠状动脉成像 分期注射法 造影剂 

分 类 号：R816.2[医药卫生—放射医学]