双源CT头颈联合双能量动脉成像肺动脉干监测优化方案研究  

Study of pulmonary artery monitoring for intracranial and cervical artery angiography with dual energy CT

作　　者：何新华 胡永胜 王自勇 杨越 付旋 费长军 范艳 王劲武 

机构地区：[1]安徽医科大学第三附属医院合肥滨湖医院影像中心,230061

出　　处：《中华放射学杂志》2012年第12期1126-1131,共6页Chinese Journal of Radiology

摘　　要：目的探讨肺动脉干监测方案在双源CT头颈部联合双能量CTA成像中的应用价值。方法60例行头颈部双能量CTA的患者按照随机数字表法分为2组，A组（优化方案组，30例）监测点位于肺动脉主干、阈值150HU、触发延迟时间为8～9s，螺距0．9，碘海醇（350mgⅠ／m1）60～65ml；B组（常规方案组，30例）监测点位于主动脉弓、阈值100HU、触发延迟时间为5S，碘海醇（350mgⅠ／ml）60～70ml。体质量〈75kg的患者注射流率为4．0ml／s，体质量≥75kg或体质量指数（BMI）≥27kg／m。者注射流率采用4．5mL／s，对比剂注射完后以相同流率追加注射40ml生理盐水。测量2组患者两侧颈总动脉、颈内外动脉、椎基底动脉、大脑中动脉水平段、注射对比剂侧锁骨下静脉、颈静脉近中远段、直窦、上矢状窦的强化CT值。2名有经验的医师采用双能量自动去骨软件、Inspace软件和3D后处理软件，行VR、MIP、CPR成像，双盲法评价CTA图像质量，评价注射对比剂侧锁骨下静脉对比剂残留伪影、头颈部静脉回流等对动脉显影的影响。应用独立样本t检验比较2组图像的CT值、图像质量评分分值等，应用卡方检验比较2组图像对比剂残留伪影、颈根部动脉起始处缺如段数、颈静脉回流严重程度等。结果两组动脉各段CT值为372～414HU，差异均无统计学意义（P值均〉0．05）。A组左、右两侧颈静脉内近、中、远段强化CT值[分别为（95±36）、（95±36）HU，（131±58）、（133±57）HU，（174±68）、180±66）HU]明显低于B组[分别为（135±58）、（137±59）HU，（170±58）、（181±58）HU，（218±62）、（224±68）HU]，两组问比较，差异有统计学意义（t值为-3．30-2．54，P值均〈0．05）。A组注射对比剂侧锁骨下静脉对比剂残留伪影例数（5例）及颈根部动脉起始处缺如段数（11段）少于B组（12例，24段），差异有统计学意义（χ2Objective To explore the application value of pulmonary artery monitoring program for intracranial and cervical artery angiography with dual-energy CT. Methods Sixty patients performed intracranial and cervical artery angiography with dual-energy CT were divided into two groups according to the random number table. Group A （optimization group,30 patients） ： the monitoring points were located in the main pulmonary artery, with threshold 150 HU, trigger delay time 8--9 s, pitch 0. 9, and the iohexol （350 mg Ⅰ/ml ） 60---65 ml. Group B （conventional group, 30 patients） ： the monitoring points were located in aortic arch, with threshold 100 HU, trigger delay time 5 s, and the iohexol （350 mg Ⅰ/ml ）60--70 ml. Patients with the body weight less than 75 kg were injected with the flow rate of 4. 0 ml/s, and those weight greater than 75 kg or with body mass index （ BMI ） greater than 27 kg/m2 were 4. 5 ml/s, following 40 mlsaline solution with the same flow rate respectively. All images were transferred to Siemens Syngo workstation for further processing and analysis. The attenuation values were measured on axial images in the common carotid artery, internal and external carotid artery , vertebral and basilar artery, the horizontal segment of the middle cerebral artery , the subclavian vein of injection side, the proximal, middle and distal segment of jugular vein, the straight sinus and the superior sagittal sinus. Two experienced observers blinded independently evaluated the image quality of CTA, the impact of contrast material residues artifacts of subclavian vein of injected side and the affect of venous return factors on arterial image display. Images of volume rendering technique（ VR）, the maximum intensity projection（ MIP）, and curved planar reformation （CPR） were reconstructed using dual energy bone removal and Inspace and 3D software . The mean intraluminal attenuation of contrast material （ HU）, the volume of contrast material and the mean image quality scores were comp

关 键 词：体层摄影术 X线计算机 对比研究 肺动脉 

分 类 号：R816.2[医药卫生—放射医学]