单次对比增强双源CT双能量肺灌注成像对比剂注射方案的优化  

Optimization of contrast media injection plan in dual-energy lung perfusion imaging using dual-source CT with single contrast enhancement

作　　者：崔兴宇[1] 方向明[1] 蔡崧[2] 钱萍艳[1] 侯金玲[1] 鲍健[1] 陈宏伟[1] 

机构地区：[1]南京医科大学附属无锡人民医院影像科,江苏无锡214023 [2]无锡市中医医院放射科

出　　处：《实用放射学杂志》2013年第9期1496-1499,1536,共5页Journal of Practical Radiology

摘　　要：目的 探讨不同对比剂注射方案对双源CT（DSCT）双能量肺灌注成像质量的影响,确定最佳方案.方法 扫描参数相同,72例患者随机分为6组,组1~3：对比剂浓度320 mg I/mL,用量1.5 mL/kg,注射速率分别为3、4、5 mL/s;组4、5：对比剂浓度320 mg I/mL,注射速率4 mL/s,用量分别为2.0、1.0 mL/kg;组6：对比剂浓度370 mg I/mL,注射速率4 mL/s,用量1.5 mL/kg.测量升主动脉、肺动脉主干及上腔静脉CT值,观察肺动脉分支显示级别和上腔静脉线束硬化伪影出现情况,对DSCT双能量肺灌注及肺动脉CT血管造影（CTA）的影像质量进行评分.不同组间各感兴趣区CT值的比较采用单因素方差分析,影像质量评分的比较采用等级资料的秩和检验.结果 组2肺动脉强化值高于组1、组5,上腔静脉强化值低于组3、组4和组6,差别有统计学意义（P＆lt;0.05）.对于双能量肺灌注图像质量评分组2优于组3、组4和组6,肺动脉图像质量评分组2优于组1和组5,其差别均有统计学意义（P＆lt;0.05）.结论 组2的对比剂注射方案可同时获得满意的双能量肺灌注成像及肺动脉CTA的图像,建议采用组2的对比剂注射方案.Objective To evaluate the impact of different contrast media injection plans on image quality of dual-energy lung perfusion imaging, and to determine the most appropriate injection plan. Methods 72 patients were randomly divided into 6 groups with identical scanning parameters,Group 1 to 3： contrast medium 320 mgl/mL, dosage 1.5 mL/kg, and injection rate of 3, 4 and 5 miffs respectively; Group 4 and 5： contrast medium 320 mgI/mL, injection rate of 4 mL/s, and dosage 2.0 and 1.0 mL/kg respectively; Group 6： contrast 370 mg/mL, dosage 1.5 mL/kg, and injection rate of 4 miffs. CT values on ascending aorta, pulmonary trunk and superior vena cava were measured. Display of pulmonary artery branches and the beam hardening artifact of superior vena cava were observed. Image quality scores of pulmonary artery on CTA and dual-energy lung perfusion imaging were also assessed. CT values for regions of interest （ROI） among different groups were analyzed with one-way analysis of variance, and ima- ging quality scores were analyzed with rank sum test of ranked data. Results The enhanced CT value of pulmonary trunk in Group 2 was higher than that in Group 1 and 5, however, the value of superior vena cava in Group 2 was lower than that in Group 3, 4 and 6, which exhibited statistical differences （P〈0.05）. The dual-energy lung perfusion imaging quality score in Group 2 was superior to that in Group 3, 4 and 6, and the image quality score of pulmonary artery in Group 2 was also superior to that in Group 1 and 5, which also exhibited statistical differences （P〈0. 05）. Conclusion Contrast media injection plan of Group 2 provides better image quality for lung dual-energy perfusion imaging and puhnonary CTA simuhaneously. Hence, this plan can be recommended for clinical routine use.

关 键 词：肺 计算机体层成像 灌注 双能量成像 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]