基于全体质量、去脂肪体质量和体表面积计算肝脏CT增强碘对比剂用量的对比研究  

Comparative study among total body weight,lean body weight and body surface area adj usted iodine contrast agent dose protocols on liver enhanced CT scans

作　　者：胡茂清[1] 龙昉[1] 龙晚生[1] 温孟皇[2] 刘再毅[2] 梁长虹[2] HU Maoqing;LONG Fang;LONG Wansheng;WEN Menghuang;LIU Zaiyi;LIANG Changhong(Departnent of Radiology,Jiangmen Cerdral Hospital,Jiangmen,Guangdong Province 529030,China;Department of Radiology,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]江门市中心医院放射科,广东江门529030 [2]广东省人民医院放射科广东省医学科学院,广东广州510080

出　　处：《实用放射学杂志》2019年第11期1831-1835,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81271654)。

摘　　要：目的探讨全体质量(TBW)、去脂肪体质量(LBW)和体表面积(BSA)三者中,适合计算肝脏CT多期增强扫描碘对比剂用量的最佳指数.方法220例患者根据碘对比剂用量随机分成3组,TBW组(75例)、LBW组(72例)和BSA组(73例)碘用量分别是600 mg I/TBW(kg)、780 mg I/LBW(kg)和22 g I/BSA(m^2).所有患者都进行上腹部CT平扫和3期增强扫描.评价肝动脉期主动脉、门静脉期门静脉和肝脏强化值(ΔHU)的差异,肝脏调整的最大强化值(aMHE)与TBW、LBW和BSA的相关性.结果TBW组、LBW组和BSA组主动脉、门静脉、肝脏ΔHU无明显差异,LBW组的主动脉、门静脉、肝脏ΔHU值的变异范围最小.肝脏aMHE与TBW、LBW和BSA的相关性分别是0.230(P=0.047)、0.158(P=0.185)和-0.154(P=0.192).结论与TBW和BSA相比,以LBW为指数计算肝脏CT多期增强碘对比剂用量时,患者与患者之间主动脉、门静脉和肝脏的强化值差异最小,是三者中计算碘对比剂用量的最佳身体指数.Objective To explore the optimal body size index for the calculation of iodine contrast agent dose required for multiphase liver enhanced CT scans based on the total body weight(TBW),lean body weight(LBW)and body surface area(BSA).Methods Two hundred and twenty enrolled patients were randomly divided into three groups,TBW-group(n=75),LBW-group(n=72)and BSA-group(n=73),and administrated iodine doses were 600 mg I/TBW(kg),780 mg I/LBW(kg)and 22 g I/BSA(m^2),respectively.All patients had taken upper abdominal plain scans and triple-phase enhanced CT scans.The enhanced values(ΔHU)of the aorta at hepatic arterial phase(HAP),the portal vein and liver parenchyma at portal venous phase(PVP)were compared.The correlation coefficients of adjusted maximal hepatic enhancement(aMHE)with TBW,LBW and BSA in three groups were evaluated,respectively.Results There were no statistical differences in theΔHU values of the aorta at HAP and the portal vein and liver parenchyma at PVP in the three groups respectively.The smallest variances of the aorta at HAP,the portal vein and liver parenchyma at PVP were found in the LBW group.The aMHE showed mildly positive correlation with TBW(r=0.230)with a P value of 0.047,but it was consistent with LBW(r=0.158)and BSA(r=-0.154)with corresponding P values of 0.185 and 0.192,respectively.Conclusion Compared with TBW and BSA,iodine contrast agent dose calculated based on the patient’s LBW can improve the patient-to-patient uniformities on aorta,portal vein and liver enhancement during the liver multiphase enhanced CT scans.The LBW is the best body index for the calculation of iodine dose on liver enhanced CT scans.

关 键 词：对比剂 计算机体层成像 全体质量 去脂肪体质量 体表面积 

分 类 号：R814.42[医药卫生—影像医学与核医学] R322.47[医药卫生—放射医学]