较低浓度碘对比剂对64排螺旋CT冠状动脉成像质量影响  

Study on relationship between expression of neural nitric oxide synthase and congenital hypertrophic pyloric stenosis

作　　者：胡冬冬[1] 黎雪琴[1] 石林平[1] HU Dong-dong LI Xue-qin SHI Lin-ping(Department of Radiology, Hubei Provincial Corps Hospital of PAP, Wuhan 430061, China)

机构地区：[1]武警湖北总队医院放射科,湖北武汉430061

出　　处：《武警后勤学院学报（医学版）》2016年第11期882-885,898,共5页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨较低浓度碘对比剂（320mg／m1）64排螺旋CT冠状动脉成像质量。【方法】对比剂选择碘氟醇320（320mg／m1）和碘普罗胺370（370mg／m1）。体外实验：2种对比剂分别于生理盐水按1：16、1：32、1：64、1：128稀释，各取5m1分别注入直径10mm塑料试管内，每个稀释比例3支试管，封闭后CT扫描，测量CT值。临床观察：同期行CT冠状动脉成像患者随机分为碘氟醇320组（320组，32例）和碘普罗胺370组（370组，31例），2组对比剂注射方式及总容量相同，扫描方式相同。观察内容：（1）血管强化程度评价。测量感兴趣区cT值，测量点包括：左冠状动脉主干（1eft main artery，LM）、左前降支（1eft anterior descending artery，LAD）、左回旋支（1eft circumflex artery，LCX）、右冠状动脉（right coronary artery，RCA）。测量点为近段10mm以内部分？（2）冠状动脉成像质量评价。成像质量分优良（充盈良好，管壁清晰锐利，对比良好，3级以上分支显示清楚，满足诊断要求）、一般（充盈尚可，管壁可辨认，对比一般，3级以上分支显示不清，可进行大致诊断）、差（充盈差，管壁模糊，对比差，诊断困难）3个等级。【结果】体外实验：4种稀释比例所测得CT值碘普罗胺370组均高于碘氟醇320组，差异具显著性。两种浓度对比剂CT值250HU以上的稀释比例范围均为l：16～1：32。临床观察中，各感兴趣区所测得CT值370组均高于320组，统计学处理显示，差异具显著性（P〈0．05，P〈O．01）。2组病例冠脉成像质量基本都达到了诊断要求，320组良好率为71．875％，370组良好率为77．419％，统计学处理差异无显著性（19〈0．05）。【结论】64排螺旋cT冠状动脉成像时较低浓度对比剂320mgI／ml达到有效血管强化程度的比例与370mg／ml对比剂基本相同，能在基本满足诊断需要的同时降低总碘剂量，�[Objective] To explore the quality of coronary 64 slice spiral CT angiography with iodine contrast medium in a low concentration （320 mghnl）. [Methods] Ioversol 320 （320 mgI/ml） and iopromide 370 （370 mgI/ml） were chosen as iodine contrast media. The experiments in vitro were as follows： the two contrast media were diluted in physiological saline respectively according to the ratios of 1：16, 1：32, 1：64 and 1：128; each plastic tuhe with the diameter of 10 mm was infused with 5 ml diluent, 3 test tubes for each dilution ratio; the tubes were closed and scanned with CT, and the CT values were measured. Clinically, patients with coronary CT angiography in the same period were randomly divided into ioversol 320 group （320 group, 32 cases） and iopromide 370 group （370 group, 31 cases）. The injection method and total capacity of contrast media as well as the scanning method were same in both groups. The following contents were observed： 1. the intensive degree of blood vessels was evaluated, and the CT values of interested areas were measured in the near segment less than 10 mm, including left main coronary artery （LM）, left anterior descending artery （LAD）, left circumflex artery （LCX） and right coronary artery （RCA）; 2. the quality of coronary angiography was evaluated as excellent imaging （good filling, clear sharp wall, good contrast, clear branches beyond class 3 and satisfiable requirement for diagnosis）, general imaging （general filling, identifiable wall, common contrast, unclear branches beyond class 3 and approximate diagnosis） and inferior imaging （bad filling, fuzzy wall, poor contrast and diagnostic difficulties）. [Results] The experiments in vitro indicated that CT values of 370 group were higher than those of 320 group in 4 dilution ratios and the difference was significant; the dilution ratio scopes of the two contrast media were all 1：16 - 1：32 when CT values were more than 250 HU. Clinical observation showed that CT values of interested ar

关 键 词：冠状动脉 血管成像 体层摄影术 X线计算机 对比剂 

分 类 号：R816.2[医药卫生—放射医学]