低浓度对比剂结合双低剂量在CT肺动脉血管成像中的临床应用  

Application of Low Concentration Contrast Agent Combined Double Low Dose in CT Pulmonary Angiography for Pulmonary Embolism

作　　者：李磊[1] 赵飞[1] 蒲钰镁 张凯[1] 蒲进[1] 李玉明[1] 彭婉琳 张金戈[1] 夏春潮[1] 李真林[1] 

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《四川大学学报（医学版）》2018年第2期239-242,共4页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅重点研发项目(No.2017SZ0016)资助

摘　　要：目的探讨低浓度对比剂结合双低剂量在CT肺动脉血管成像(CTPA)中的应用价值。方法连续纳入临床怀疑肺动脉栓塞行CTPA检查患者60例,随机分为2组,每组30例,其中试验组采用80kV,碘克沙醇(320mg/mL)15mL;对照组采用120kV,碘必乐(370mg/mL)50mL。测量肺动脉干及左、右肺动脉和各叶动脉CT值(取平均值),同时对原始数据进行最大密度投影(MIP)、曲面重建(CPR)和容积再现(VR)重建,由两名高年资放射科医师采用双盲法对图像整体质量和上腔静脉污染进行评分评价。结果所有患者均成功完成CTPA成像,且图像整体质量均满足临床诊断需求,差异无统汁学意义(P>0.05);实验组静脉污染评分优于对照组,差异有统计学意义(P<0.01)。实验组的CT值[(423.2±89.4)HU]与对照组CT值[(465.7±85.6)HU]差异无统计学意义(P>0.05)。实验组肺动脉信噪比(SNR)、对比噪声比(CNR)均低于对照组,差异有统计学意义(P均<0.01)。实验组辐射剂量容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)和体型特异性剂量估量值(SSDE)均比对照组低,差异有统计学意义(P均<0.01)。结论低浓度对比剂结合双低剂量CTPA成像可获得满足临床诊断的图像,减轻了静脉污染,降低了碘对比剂用量及患者的辐射剂量,具有良好的临床应用价值。Objective To investigate the feasibility of low concentration contrast agent combined double low dose in CT pulmonary angiography. Methods 60 patients with clinically suspected pulmonary embolism examed by CT pulmonary angiography （CTPA） were divided into two groups （experimental group., n= 30, 80 kV, 15 mL, 320 mg I/mL; control group： n=30, 120 kV, 50 mL, 370 mg I/mL）. The average CT value of main right and left pulmonary arteries, lobar arteries was calculated. Imaging post processing techniques included curved plannar reconstruction （CPR）, volume rendering （VR） and maximal intensity projection （M/P）. The artifact of the remaining contract in the superior vena cava and overall quality of the image were observed and analyzed by two senior doctors who were double blinded. Results All patients in two groups completed CTPA successfully. The image qualities of two groupssatisfy clinical diagnostic requirements and no difference of the image qualities was observed between two groups （P〉0.05）. The evaluation of venous pollution in experimental group was better than that of control group （P〈0.01）. No difference of CT values were observed between two groups [experimental group （423.2±89.4） HU, control group （465.75±85.6） HU] （P〉0.05）. The SNR and CNR in experimental group were lower than those in control group （P〈0.01 both）. The CT dose index volume （CTDIvol）, dose-length product （DLP） and size-specific dose estimates （SSDE） in experimental group were significantly lower than those incontrol group （P〈0.01 all）. Conclusion The low concentration contrast agent combined double low dose in CT pulmonary angiography satisfies clinical diagnostic requirements. It has good clinical value for it could reduce venous pollution, iodine contrast agent and radiation exposure.

关 键 词：肺栓塞 对比剂 血管造影术 X线计算机 体层摄影术 

分 类 号：R543.2[医药卫生—心血管疾病]