冠状动脉CT成像中个体化对比剂注射方案提高不同浓度对比剂强化均一性的价值  

Value of using individual contrast injection protocol with different contrast concentration to improve contrast uniformity in coronary CT angiography

作　　者：邢艳[1] 潘存雪[1] 古丽娜·阿扎提[1] 刘文亚[1] 肖虎[1] 党军[1] 马海婷[1] 李晶晶[1] 

机构地区：[1]新疆医科大学第一附属医院影像中心,乌鲁木齐830011

出　　处：《中华放射学杂志》2015年第11期853-857,共5页Chinese Journal of Radiology

基　　金：新疆维吾尔自治区自然科学基金面上项目（2013211A083）

摘　　要：目的探讨冠状动脉CT血管成像（CCTA）中，采用个体化对比剂注射方案提高不同浓度对比剂强化均一性的价值。方法前瞻性收集临床疑诊为冠心病申请行CCTA检查的连续患者240例，采用随机数字表法分为实验组及对照组，每组120例。实验组和对照组患者再分别采用数字表法随机分为4个亚组，每个亚组30例，分别应用碘含量为300、320、350、370mg／ml的对比剂（亚组1—4）。实验组不同亚组患者根据公式计算对比剂用量及注射流率，时比剂用量=（体质量×280mg／kg）／对比剂碘含量，注射流率=对比剂用量／12s。对照组以5．5ml／s的流率注射对比剂80ml。两组患者其他参数一致。测量主动脉根部、左主干、左前降支近段、左回旋支近段、右冠状动脉近段及右冠状动脉远段至后降支的强化CT值，并记录对比剂用量和注射流率。实验组、对照组不同亚组CT值的比较采用单因素方差分析，组内两两比较采用LSD法，实验组和对照组对比剂用量、注射流率的比较采用t检验。结果实验组各亚组间目标血管强化CT值为348—396HU，各亚组强化CT值的差异均无统计学意义（尸均〉0．05）；对照组各亚组间目标血管强化CT值为256～396HU，差异均有统计学意义，且370、350mg／ml对比剂亚组患者的目标血管强化CT值均高于300mg／ml对比剂亚组（P均〈0．05）。实验组亚组1—4组患者的对比剂用量分别为（67±9）、（64±8）、（62±7）、（61±7）ml，与对照组的差异均有统计学意义（t值分别为10．04、12．49、14．55和15．24，P均〈0．01）。实验组亚组1～4组患者的对比剂注射流率分别为（5．5±0．6）、（5．2±0．7）、（5．1±0．6）、（5．0±0．6）ml／s，亚组1和对照组的对比剂注射流率差异无统计学意义（t=0．06，P〉0．05），其他亚组和对照组的注射流率差异均有统计学意义（t值分别�Objective To determine the value of individual injection protocols to result in more homogeneous vascular attenuation in coronary CT angiography （CCTA）. Methods Two hundred and forty patients with suspicious coronary heart disease and underwent CCTA were prospectively randomized into experimental group （n=120） and control group （n=120）. Four subgroups with each thirty subjects were divided randomly to use different contrast concentration （300, 320, 350 and 370 mg/ml）. In the experimental group, injection protocols were determined by the formula： contrast dosage （ml） =[（weight × 280 mg/kg）/ contrast concentration], injection rate （ml/s） = （contrast dosage/12 s）. Other parameters between two groups were same. In the control group, patients received a fixed dose of 80 ml of contrast medium at 5.5 ml/s. For each patient, CT values of aorta, left main artery, left anterior descending branch, left circumflex branch and right coronary artery were measured, meanwhile contrast dosage and injection rate were recorded. One-way analysis of variance was used to compare CT attenuation among subgroups, inter-group comparison wasperformed with LSD method. Contrast dosage and injection rate between two groups were compared with t test. Results Under the experimental group, CT attenuations were between 348 to 396 HU, which showed no significant difference among target arteries （all P〉 0.05）. Under the control group, CT attenuations were between 256 to 396 HU, which showed significantly different among target arteries （all P〈0.05）, and the attenuation with contrast concentration of 300 mg/ml was significantly lower than that with 370 mg/ml or 350 mg/ml. The average contrast dosage in experimental subgroup 1 to 4 were （67±9）,（64±8）,（62±7）,（61±7） ml, lower than those in control subgroups （t value were 10.04,12.49,14.55 and 15.24, all P〈0.01）. The average injection rate in experimental subgroup 1 to 4 was （5.5±0.6）,（5.2±0.7）,（5.1±0.6）,（5.0±0.6�

关 键 词：冠状动脉 体层摄影术  x线计算机 造影剂 

分 类 号：R816.2[医药卫生—放射医学]