对比剂分次团注在CT门静脉成像中的应用价值  

The application value of fractional contrast medium bolus injection in CT portography

作　　者：王延春[1] 祝则峰[1] 吴燕萍[1] 黄益隽 董雪[1] 张灵飞[1] 

机构地区：[1]浙江省嘉兴市第一医院放射科

出　　处：《中国生化药物杂志》2017年第5期438-440,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨对比剂分次团注在提高肝硬化门静脉高压症患者CT门静脉成像图像质量的价值。方法将符合纳入标准的42例肝硬化门静脉高压患者随机分为2组,对比剂均采用碘海醇（350 mg I/m L）。A组20例,采用常规对比剂注射方式,对比剂用量为100 m L,注射流率4 m L/s。B组22例,采用对比剂分次团注方式,第1期注入对比剂60 m L,注射流率4 m L/s,20 m L生理盐水以同流率冲管,延迟10 s后再次以4 m L/s流率注入40 m L对比剂,再用20 m L生理盐水同速冲管。根据原始图像和后处理图像评价门静脉系统图像质量和测量CT值,采用独立样本t检验比较门静脉主干、脾静脉、肠系膜上静脉、肝实质的CT值。非参数秩和检验比较门静脉-肝实质的CT值及图像质量主观评价得分,Kappa检验评价主管评分的一致性。结果 B组患者门静脉主干、脾静脉及门静脉主干-肝实质差值均高于A组,两组间差异有统计学意义（t=3.317,3.523,P〈0.01）;肝实质和肠系膜上静脉CT值2组间差异无统计学意义。2组图像主观质量评分：常规注射方式组为（3.60±0.82）分,分次团注组为（4.77±0.81）分,B组优于A组,且差异有统计学意义,两位评价医师结论一致性好。结论对比剂分次团注技术在相同对比剂用量的前提下,能显著提高门静脉高压患者的门静脉CT成像质量。Objective To investigate the value of fractional contrast medium bolus injection in improving the quality of CT portography.MethodsA total of 42 patients were randomly divided into two groups which were all given iohexol （350mgI/mL） as the contrast medium.20 patients in the group A were injected with conventional method （dosage of 100ml, rate of 4mL/s）.The group B （22 patients） were treated with fractional contrast medium bolus injection, the first phase with 60mL contrast medium （rate of 4mL/s） and the second phase （10s delayed） with 40mL contrast medium （rate of 4m/s）.The tube was washed by 20mL saline with the same rate of injection at both phases.The CT values and the image quality of the branches of the portal vein were evaluated according to the original and postprocessed images.Independent samples test was used to compare the CT values of the portal vein, splenic vein, superior mesenteric vein, hepatic parenchyma and portal vein-liver parenchyma.The subjective evaluation scores of the image quality were compared by wilcoxon.ResultsThe CT values of the portal vein, splenic vein and portal vein-liver parenchyma in the group B were significantly higher than that in the group A （t=3.317,3.523,P〈0.01）.There was no significant difference in CT values of hepatic parenchyma and superior mesenteric vein between the two groups.Subjective quality score in the group B was superior to that in the group A, and the difference was statistically significant.T The two evaluation physicians agreed well.ConclusionThe technique of fractional contrast medium bolus injection can significantly improve the image quality of CT portograghy.

关 键 词：门静脉 体层摄影术 X线计算机 对比剂 

分 类 号：R445.3[医药卫生—影像医学与核医学]