正常肝脏与肝硬化螺旋CT扫描时对比剂最优化使用方法的研究  

Study on the optimal use of contrast media in spiral CT scanning:comparison between normal liver and cirrhotic liver

作　　者：王敏杰[1] 王培军[1] 田建明[1] 左长京[1] 王鸣鹏[2] 薛宏[1] 范月兰[1] 

机构地区：[1]第二军医大学长海医院放射科,上海200433 [2]上海华东医院放射科

出　　处：《中华放射学杂志》2002年第5期426-429,共4页Chinese Journal of Radiology

摘　　要：目的　研究正常肝脏与肝硬化肝脏在螺旋CT增强多期扫描中最佳对比剂剂量、注射流率及各组织强化达到峰值的时间。方法　正常肝脏、肝硬化肝脏各 6 0例 ,按完全随机设计法各分成 6组 ,分别以不同的注射剂量及流率在肘静脉注射非离子型对比剂 ,并在同一层面作连续多层扫描。最后测量各组织CT值 ,建立统计表并相互比较。结果　正常肝脏当注射剂量为 1 5ml/kg时 ,3种不同的注射流率除主动脉强化峰值两两比较统计学上差异均有显著性意义外 (P <0 0 5 ) ,门静脉、肝实质差异均无显著性意义 (P >0 0 5 ) ;当注射流率为 2 5ml/s时 ,不同的剂量强化峰值主动脉、门静脉、肝实质差异均有显著性意义 (P <0 0 5 )。肝硬化组 :当注射剂量为 2 0ml/kg时 ,3种不同的注射流率时肝实质在 2 5ml/s与 3 0ml/s时强化峰值差异有显著性意义 (P <0 0 5 )。当注射流率为3 0ml/s时 ,不同的剂量肝实质强化峰值差异有显著性意义 (P <0 0 5 )。结论　正常肝脏与肝硬化肝脏的螺旋CT增强扫描的最佳剂量、注射流率应分别为 1 5ml/kg、2 5ml/s和 2 0ml/kg、3 0ml/s。其主动脉、门静脉及肝实质达到峰值的时间分别为 :2 8s、5 2s、73s和 31s、6 8s、77s。Objective To investigate the optimal injection dose and rates of contrast media and the peak enhanced times of different tissues when the normal and cirrhotic livers were examined by contrast-enhanced multiphase spiral CT. Methods Sixty cases of normal livers and 60 cases of cirrhotic livers were divided into 6 groups respectively by complete random method. Different dose of contrast media was injected at different rates via the antecubital vein. Continuous scanning was carried out at the same selected level. The CT values of different tissues were measured to establish the statistical tables. Results In normal liver cases, when the volume of contrast media injected were 1.5 ml/kg, the peak value of aorta at 3 different rates had obvious statistical difference ( P <0.05) between every two groups, but the peak value of portal vein and liver parenchyma had no statistical difference ( P >0.05) between every two groups. When the contrast media were injected at a rate of 2.5 ml/s, the peak values of aorta, portal vein, and liver parenchyma at 3 different volumes of contrast media had obvious statistical difference ( P <0.05) between every two groups. In patients with liver cirrhosis, when the volume of contrast injected were 2.0 ml/kg, the peak values of liver parenchyma had obvious statistical difference ( P <0.05) at rates of 2.5 ml/s and 3.0 ml/s. When injection rate was 3.0 ml/s, the peak values of liver parenchyma had obvious statistical difference ( P <0.05). Conclusion When the livers were examined by contrast-enhanced multiphase spiral CT, the optimal injection dose and rates of contrast media for normal livers were 1.5 ml/kg and 2.5 ml/s, and for cirrhotic livers 2.0 ml/kg and 3.0 ml/s, respectively. In the normal liver group, the peak enhanced times of the aorta, portal vein, and liver parenchyma were 28 s, 52 s, and 73 s, respectively. In the cirrhotic liver group, the times were 31 s, 68 s, and 77 s, respectively.

关 键 词：肝硬化 螺旋CT 对比剂 最优化使用谅研究 

分 类 号：R814.3[医药卫生—影像医学与核医学]