应用定量CT骨测量技术评价骨密度与静脉注射造影剂间的关系  

Relationship between bone mineral density and intravenous contrast media: a radiographic study via quantitative CT detection

作　　者：周巍[1] 杨本强[1] 

机构地区：[1]沈阳军区总医院放射诊断科,辽宁沈阳110016

出　　处：《临床军医杂志》2015年第6期599-602,共4页Clinical Journal of Medical Officers

摘　　要：目的通过定量CT骨检测(QTC),评估受试者注射增强造影剂前后骨密度(BMD)的变化。方法自2014年5月至2015年3月,共166例患者(其中106例无肾癌者,60例肾癌患者),同时接受腹部CT扫描,通过测量腰1椎体的CT值,记录三期(平扫、动脉期及静脉期)的骨密度(BMD)变化。结果注射增强剂的两组(动脉期及静脉期)CT衰减值比无注射组(平扫期)显著增高(P<0.01)。无肾癌组:增强组动脉期CT值由(127.6±46.3)HU增长至(141.2±46.2)HU,静脉期增长至(146.3±47.1)HU(P<0.01)。肾癌组:增强组动脉期CT值由(113.2±37.8)HU增长至(125.2±38.2)HU,静脉期增长至(131.2±36.1)HU(P<0.05)。结论 QCT对有肾癌组及无肾癌组患者进行三期(平扫、动脉期及静脉期)骨密度检测,注射增强造影剂均大幅度增加骨衰减,因此,造影剂对CT检测骨质疏松程度存在干扰,提示临床诊断骨质疏松症时须将造影剂的影响考虑在内。Objective To evaluate the effect of intravenous contrast media on bone mineral density（ BMD） assessment by comparing unenhanced and contrast-enhanced computed tomography（ CT） examinations performed for other indications. Methods One hundred and sixty-six patients（ 106 without and 60 with malignant neoplasm） who underwent both unenhanced and two contrast-enhanced（ arterial and portal venous phase） abdominal CT examinations in a single session between May 2014 and March 2015 were included. BMD was evaluated on the three examinations as CT-attenuation values in Hounsfield Units（ HU） in the first lumbar vertebra（ L1）. Results CT-attenuation values were significantly higher in both contrast-enhanced phases,compared to the unenhanced phase（ P 〈0. 01）. In patients without malignancies,HU-values increased from（ 127. 6 ± 46. 3） HU for the unenhanced phase to（ 141. 2 ± 46. 2） HU for the arterial phase and（ 146. 3 ± 47. 1） HU for the portal phase（ P 〈0. 01）. In patients with malignancies,HU-values increased from（ 113. 2 ± 37. 8） HU to（ 125. 2 ± 38. 2） HU and（ 131. 2 ± 36. 1） HU（ P 〈0. 05）,respectively. Conclusion Our study showed that intra-venous contrast injection substantially affects BMD-assessment on CT and taking this into account may improve routine assessment of low BMD in nonquantit-ative CT,in the future,it should be taken into consideration.

关 键 词：骨质疏松 筛查 CT检查 造影剂 骨密度 

分 类 号：R814.42[医药卫生—影像医学与核医学]