螺旋 CT在肺动脉及下肢静脉联合检查中的成像方法  

Method and technique of multislice spiral CT pulmonary angiography in combination with venography

作　　者：严由伦[1] 李荣[1] 姜永宏[1] 余建国[1] 薛明[1] 

机构地区：[1]西安市红十字会医院影像科,陕西西安710054

出　　处：《实用放射学杂志》2012年第5期775-779,共5页Journal of Practical Radiology

摘　　要：目的 探讨造影剂双期注射方法在多层螺旋CT肺动脉造影联合下肢静脉造影（CTVPA）中的技术应用.方法 应用多层螺旋CT对30例疑似肺动脉栓塞的病人进行肺动脉造影（CTPA）联合下肢深静脉造影（CTV）.A组（15例）采用120-150 mL对比剂,注射速率4 mL/s.B组（15例）采用120-150 mL对比剂,双期注射,第一期50 mL,注射速率4 mL/s,第二期注射70-110 mL对比剂,注射速率2 mL/s,为对照组（B组）.对肺动脉各级血管CT均值和下肢静脉血管CT均值进行测量及上腔静脉伪影进行评价.结果 30例检查中肺动脉各级血管和下肢静脉均得到良好的强化,2组无显著性差异.上腔静脉伪影评价,B组上腔静脉伪影对右肺动脉及右上叶动脉的影响明显少于A组,存在显著性差异（P＜0.05）.结论 应用双期对比剂注射方法可以得到良好的肺动脉各级血管和下肢深静脉的强化,并可降低上腔静脉伪影的影响,可作为CTVPA的有效检查方法.Objective To evaluate ihe technological application by using a hiphasic iniection protocol in the examination of CT venography in comhination with pulnnary angiography （CTVPA）. Methods Thirty patients with clinically suspected pulmonary embolisnl（PE） underwenl CTVPA using 16 slice spiral CT. CTVPA was performed using 120-150 nil. conlrasl material （370 mg I/mL） at a flow rate of I mL/s in 15 cases （group A）. And 120 150 nil. conlrast material with biphasic injection protocol in other 15 cases （group B） ： first phase , 50 ml. at a flow rale of 1 mL/s, second phase , 70-110 mL at a flow rate of ;2 mL/s. The attenua tion mean;tn values for each examination were measured in the main pulmonary arteriae and its branches , as well as veins of lower extremity, and the artifacts at the superior vena cave were scored at the same time. Results The enhancement in pulmonary arteriae and veins of lower extremity was excellent in all cases at CTVPA , there was no significant difference hetween group A and B（P〉0.05）. The score of the artifacts of file superiorvena cava was x2=6.878,P =0.033 in two groups, while the interference of the arti facts of the superior wna cava on right puhnonary and right upper lobe pulmonary arteriae in group B was lower than these in group A（ P〈0. 051. Conclusion The biplasic injection protocol using 120-150 mLcontrast material can obtain the fine enhancement de gree in the pulmonary artery and the lower extremity deep vein, and the effect of superior vena cava artifacts on pulmonary arteriae is reduced in certain degree, so the technique of biphasic injection protocol can be employed effectually at CTVPA examinations.

关 键 词：肺 肺动脉栓塞 血管造影 体层摄影术 X线计算机 

分 类 号：R563.5[医药卫生—呼吸系统]