不同剂量对比剂在64排螺旋CT脑动脉成像中的比较研究  

Comparative study on various dosage contrast agents in 64-detector row CT cerebral angiography

作　　者：石林平[1] 黎雪琴[1] 李长英[2] 郝光远[1] 罗红亮[1] 郑石林[1] 

机构地区：[1]武警湖北省总队医院放射科,湖北武汉430061 [2]中国人民解放军第42医院放射科,四川乐山614199

出　　处：《生物医学工程与临床》2014年第6期544-548,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的比较64排螺旋CT脑动脉成像（CTA）检查中不同剂量对比剂脑动脉显影质量,探讨在保证图像质量的前提下,使用合适的对比剂剂量。方法怀疑或已知颅内血管性病变患者183例,其中男性97例,女性86例;年龄41~75岁,平均年龄56岁。行脑CTA,对比剂为碘普罗胺（370 mg I/m L）。按对比剂注射量分成3组,A组50 m L者64例,B组70 m L者60例,C组90 m L者59例。注射对比剂之后用相同流速0.9%氯化钠溶液30 m L冲刷,对比剂流速4.5 m L/s。测量左右侧颈内动脉、大脑前动脉A2段、大脑中动脉M2段、大脑后动脉P2段和基底动脉、大脑大静脉、上矢状窦、优势乙状窦,共12处CT值;图像质量由2名高年资放射诊断医生依据动脉内对比剂充盈、动脉轮廓、静脉显影、诊断可靠性情况按5分制评分。结果 3组患者年龄、性别、心率及体质量指数差异无统计学意义（P〉0.05）。183例患者检查均成功,3组间图像质量评分差异无统计学意义（P〉0.05）;A组右侧A2段、上矢状窦、乙状窦强化较B组和C组低,差异有统计学意义（t=-2.365,P=0.033;t=-2.576,P=0.021;t=-2.782,P=0.019;t=-3.014,P=0.006）;其余血管CT值差异无统计学意义（P〉0.05）。图像质量上B组和C组动脉轮廓显示较A组好,但是A组静脉显影较B和C组更少。结论 64排螺旋脑CTA中使用对比剂50 m L（370 mg I/m L）不影响图像质量,还可减少对比剂使用的不良反应,并减轻患者经济负担。Objective To compare the imaging quality of various dosage contrast agents, and explore the effect of various dosage contrast agents on vascular enhancement in 64-detector row CT cerebral angiography（CTA）. Methods A total of 183 patients with suspected or confirmed intracranial vascular disease were enrolled, included 97 males and 86 females, aged 41- 75 years old with mean age of 56. All of them were performed CTA with Iopromide（370 mg I/m L） as the contrast agents. They were divided into 3groups in injection quantity, with group A（n = 64）, B（n = 60） and C（n = 59） received 50 m L, 70 m L and 90 m L contrast agents,respectively. After injection of the contrast agents, 30 m L 0.9 % sodium chloride solution was used for flushing at the same flow rate of contrast agents injection（4.5 m L/s）. The CT values were measured on transverse images at right and left internal carotid arteries, A2 segment, M2 segment, and P2 segment, basilar artery, great cerebral vein, superior sagittal sinus, and dominant sigmoid sinus. The image quality parameters（intra-arterial contrast, arterial delineation, venous contamination, and confidence in diagnosis） were graded by 2 experienced doctors in consensus with the 5-point scale. Results The differences in age, gender, heart rates and body mass indexes were not significant among 3 groups（P〉0.05）, and the examination of 183 cases were all successful with the image quality were not significant difference among 3 groups（P〉0.05）. The CT values at right A2 segment, superior sagittal sinus and sigmoid sinus of group A were significantly lower than those of group B and C（t =- 2.365, P = 0.033; t =- 2.576, P = 0.021; t =- 2.782, P = 0.019; t =- 3.014, P = 0.006）, whereas the remaining intracranial vessels were not significantly different among 3 groups（P〉0.05）. In qualitative evaluation, arterial delineation in group B and C was better than that of group A, but intravenous contrast was less displayed in group A. Conclusion It is demonstrated that

关 键 词：脑动脉 血管造影术 对比剂 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]