使用宽体探测器捕捉肺动静脉成像最佳时间的可行性研究  

Optimal time for pulmonary arterial and venous imaging by a wide-area detector:a feasibility study

作　　者：刘元芬[1] 薛蕴菁[1] 王莉莉[1] 陈光亮[1] 陈依林 陈旭辉[1] 徐雪 段青[1] Liu Yuanfen;Xue Yunjing;Wang Lili;Chen Guangliang;Chen Yilin;Chen Xuhui;Xu Xue;Duan Qing(Imaging Department,Fujian Medical University Union Hospital)

机构地区：[1]福建医科大学附属协和医院影像科

出　　处：《重庆医科大学学报》2019年第10期1294-1297,共4页Journal of Chongqing Medical University

基　　金：福建省卫计委青年资助项目（编号：2017-1-42）

摘　　要：目的:通过对比运用灌注的多期相CTA扫描和常规单期相CTA的图像质量和辐射剂量,探讨使用宽体探测器采用灌注的扫描方式捕捉肺动脉和肺静脉成像的最佳时间的应用价值。方法:对108例因磨玻璃样影(ground-glassopacity,GGO)拟行右上肺段切除术的患者行肺部增强检查。运用Revolution CT,将患者分为2组:A组,灌注方式扫描组,54例;B组,增强跟踪自动触发扫描组,54例。A组扫描方式为采用灌注方式扫描,患者行多模式CT检查,包括肺部CT平扫、CT灌注(CT perfusion,CTP)。造影剂推注后,对感兴趣区160 mm层面内进行CT轴位扫描,扫描时相间隔为2 s,直到肺静脉期结束则停止扫描。B组扫描方式为采用常规增强跟踪自动触发方式。所有病例在肺动脉期和肺静脉期扫描图像中统一选取肺动脉主干、右肺动脉、右肺上叶动脉、右上肺尖段动脉和主动脉及其伴行静脉作为测量对象,测量其CT值和噪声(standard deviation,SD)值且计算4组CT值差,并用积分法评价5、6级肺动脉和肺静脉的显示情况。结果:除了3级(P=0.010)和4级(P=0.003)的CTPA肺动脉CT值存在统计学差异,其他2组1~4级肺动脉和肺静脉CT值差异均没有明显统计学意义(P>0.05)。在CTPA中动脉及伴行静脉的CT值差,以及CTPV中肺静脉与伴行动脉的CT值差中,A组在CTPA和CTPV中的差值明显高于B组,均P<0.05。运用积分法来分析5、6级肺动脉及伴行肺静脉的显示情况,结果显示2组患者的肺动脉显示上均为3分,而2组在肺静脉细小分支上的显示存在统计学差异,A组3.00(3.00,3.00),B组2.00 (1.75,3.00)(Z=2.814,P=0.005)。同时2组患者的肺动脉主干的SD值为28.45±3.47和29.47±3.80(t=0.627,P=0.539),在CTPV时候右上肺静脉的SD值为27.27±7.56和27.76±6.44(t=0.156,P=0.878),差异均没有统计学意义。结论:使用宽体探测器采用类似灌注的方式既能满足对肺动静脉CT值的要求,又能有效分离肺动静脉,对于临床开�Objective:To explore the practical value of the optimal time for pulmonary arterial and venous imaging by a wide-area detector using perfusion scanning mode by comparing the image quality and radiation dose of multi-phase computed tomography an-giography(CTA)and conventional single-phase CTA. Methods:Contrast-enhanced computed tomography(CT)of the lung was performed in 108 patients scheduled for right upper lung lobe resection due to ground-glass opacity(GGO). According to the examination results of the Revolution CT,the patients were divided into 2 groups(54 cases in each group):group A(using perfusion scanning)and group B(using automatic bolus tracking triggered by contrast enhancement). Patients in group A underwent multi-mode CT examination using perfusion scanning,including plain CT scan and CT perfusion(CTP)of the lung. After contrast agent injection,axial CT scan was performed on the 160 mm layer in a region of interest with a phase interval of 2 seconds until the end of pulmonary venous phase. Patients in group B underwent conventional CT using automatic bolus tracking triggered by contrast enhancement. The pulmonary trunk,right pulmonary artery,right upper lobe pulmonary artery,right apical pulmonary artery,aorta,and their accompanying veins were selected to be measured on the scanning images taken during the pulmonary arterial and venous phases for all the patients;the CT values and noise standard deviation(SD)were obtained from the measurement,and the differences in CT values between the four groups were calculated;meanwhile,an integral method was used for evaluation of visualization of grade 5 or 6 pulmonary arteries and veins. Results:There were no significant differences between the two groups in the CT values of grade1-4 pulmonary arteries and veins,except grade 3 and 4 pulmonary arteries(P=0.010 and 0.003),on computed tomography pulmonary angiography(CTPA)(P>0.05). Compared with group B,group A had significantly larger CT value differences between pulmonary arteries and their accompanying veins on

关 键 词：肺动脉 肺静脉 磨玻璃样影 灌注 宽体探测器 

分 类 号：R81[医药卫生—放射医学]