低剂量对比剂联合生理盐水在第二代双源CT头颈部CT血管成像中的临床应用  

Application of low-dose contrast agent combined with physiological saline in SOMATOM Definition Flash CT angiography for head and neck

作　　者：李磊[1] 赵飞[1] 夏春潮[1] 刘露[1] 李真林[1] LI Lei;ZHAO Fei;XlA Chunchao;LIU Lu;LI Zhenlin(Department of Radiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《华西医学》2018年第8期1015-1018,共4页West China Medical Journal

基　　金：国家自然科学基金(81641169);成都市科技惠民项目(2015-HM01-00473-SF)

摘　　要：目的探讨低剂量对比剂联合生理盐水在第2代双源CT头颈部CT血管成像(CT angiography,CTA)中的临床应用价值。方法连续纳入2015年3月—7月临床怀疑头颈部血管病变的患者60例,随机分为2组,试验组采用30 m L对比剂,对照组采用50 m L对比剂。对原始数据进行最大密度投影、曲面重建和容积再现重建,分别测量主动脉弓、颈总动脉分叉处、大脑中动脉M1段的CT值,由2名高年资放射科医师采用双盲法对图像整体质量及静脉污染进行评价。结果所有患者均成功完成头颈部CTA,两组图像整体质量均满足临床诊断,差异无统计学意义(P>0.05)。试验组的静脉污染轻于对照组(P<0.05)。试验组主动脉弓[(341.3±89.5)HU]、颈总动脉分叉处[(391.0±103.7)HU]、大脑中动脉M1段[(305.0±62.0)HU]的CT值略小于对照组[(437.3±83.7)、(532.5±113.3)、(396.6±93.1)HU],差异有统计学意义(P<0.05)。结论采用第2代双源CT行低剂量对比剂头颈部CTA,在满足临床诊断图像质量的同时,又降低了对比剂使用总量,减轻了静脉污染,具有良好的临床应用价值。Objective To explore the clinical value of low-dose contrast agnet in CT angiography（CTA） for head and neck by SOMATOM Definition Flash CT. Methods Sixty consecutive patients with head and neck vessel diseases examined by CTA in the head and neck were chosen from West China Hospital of Sichuan University from March to July2015, and then were randomly divided into two groups（the experimental group： n=30, 30 m L contrast medium; the control group： n=30, 50 m L contrast medium）. Imaging post processing techniques included curved plannar reconstruction, volume rendering, and maximal intensity projection. CT values of the different level of carotid arteries（aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery） were measured. The artifact of the remaining contract in the jugular vein and overall quality of the image were observed by two senior doctors using double blind method. Results All the patients in the two groups completed CTA for head and neck successfully. The image qualities of the two groups satisfid clinical diagnostic requirements, and there was no difference in the image qualities between the two groups（P〈0.05）. The evaluation of venous pollution in the experimental group was lighter than that in the control group（P〈0.05）. The CT values of aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery in the experimental group [（341.3±89.5）,（391.0±103.7）,（305.0±62.0） HU] were slightly lower than those in the control group[（437.3±83.7）,（532.5±113.3）,（396.6±93.1） HU], which were statistically significant（P〈0.05）. Conclusion Low-dose contrast in CTA for head and neck by SOMATOM Definition Flash CT can satisfy the clinical diagnostic requirements,and reduce the dose of contrast agent and venous pollution, with a good clinical value.

关 键 词：对比剂 头颈部 血管造影术 X线计算机 体层摄影术 

分 类 号：R816.1[医药卫生—放射医学]