临床肾、尿路与血管同时CT造影新技术初探  

Preliminary Study on CT Urography and Angiography (CTUA) in One Acquisition

作　　者：钱俨[1] 杨秀军[2] 程芙蓉[2] 唐磊华 

机构地区：[1]上海市第八人民医院干部病房,上海200235 [2]上海市第八人民医院放射科,上海200235

出　　处：《CT理论与应用研究（中英文）》2012年第4期713-719,共7页Computerized Tomography Theory and Applications

基　　金：上海市徐汇区医学科研重点项目(SHXH201109)

摘　　要：目的:初步探讨一次扫描同时实现CT尿路、血管造影(CTUA)的技术与方案。材料与方法:选择要求CTU检查、无显著尿路积水连续75例成年患者为研究对象,300mgI·mL-1碘海醇相隔20min两次团注各50mL,末次注射延迟20s及5min螺旋扫描肾上极至盆底各一次以分别获取CTUA及CTU源影像。分别对该两组源影像作3DVR重建,对比观察CTUA、CTU对肾、尿路、血管的显示效果。结果:CTUA技术成功率为100%,对肾皮质、髓质、肾盂肾盏的区别显示良好率为100%,明显优于CTU的0%(P=0.000,后者未能区分肾皮、髓质);对肾盂肾盏、输尿管和膀胱的显示良好率分别为95.94%、94.59%和95.95%,稍逊于CTU的100%、97.97%和98.65%(P>0.05);对肾动脉、腹主动脉、髂总动脉的显示良好率分别为87.16%、96%、81.33%,明显优于CTU的0%、0%、0%(P=0.000,后者未显示出血管)。CTUA准确揭示了肿瘤、结石、炎症、前列腺增生、动脉硬化及各种尿路、血管畸形。结论:CTUA技术可行,采用常规剂量和浓度对比剂一次静穿、两次注射、一次CT扫描即可实现。Objective：To determine preliminarily the feasibility and a one-stop strategy of CT urography and angiography in one scanning acquisition using 4-slice MDCT. Materials and methods：Seventy-five consecutive patients （41 men and 34 women; mean age 52 years; age range, 22 to 86 years） without evident hydronephrosis who asked for CT urography （CTU） examination received the new technique of CTUA using by 4-MDCT. Twice-bolus protocol consisted of 50 mL of contrast material （300 mg per milliliter of iodine） immediately after urinating at 2～2.5 mL/sec at 0 seconds and 50 mL at 3.5～4 mL/sec at 20 minutes through the forearm vein. CT scanning （CTUA） started with one breath-hold 20 seconds after the second injection with 10 mm of slice thick, 0.75：1 of pitch and 15 mm/rot of speed. Five minutes after the second injection, CT scanning started again using the same parameters for routine CTU. After thin-slice reconstruction of 5 mm thick and 2.5 mm interval, all the images data were then transferred to an ADW 4.2 workstation to post-process by 3D VR software. Excellent rate of visualization of renal parenchyma, urinary tracts, and main arteries on CTUA and CTU images were reviewed and assessed independently first and interpreted agreeably by two experienced radiologists. Statistical analysis was performed using variance analysis （ANOVA） to evaluate the difference, and P 0.05 is considered statistically significant. Results：The technique success rate of CTUA was 100%, and excretory-corticomedullary phase source images were acquired, which the good rate of distinguishing the renal cortex from the medulla and calices was 100% （148/148）, while the CTU source images were not well depicted the renal cortex, medulla and calicessimultaneously （P = 0.000）. The good opacification of the renal calices, ureter, bladder, and the renal artery, the aorta and iliac artery was achieved in 95.94% （142/148）, 94.59% （140/148）, 95.95% （71/74）, and 87.16% （129/148）, 96% （72/75）, 81.33% （12

关 键 词：肾 解剖 肾动脉造影 尿路造影 三维成像 CT血管造影 

分 类 号：R816.7[医药卫生—放射医学]