对比剂分段注射在肝硬化患者肝静脉CT造影中的应用价值  

The clinical application of contrast agent segmental injection in hepatic vein CT angiography in liver cirrhosis patients

作　　者：杨华[1] 胡勤勤 刘翠芳[1] 梁仁容 曾国飞[1] YANG Hua;HU Qinqin;LIU Cuifang;LIANG Renrong;ZENG Guofei(Department of Radiology,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院放射科,重庆400021

出　　处：《实用放射学杂志》2019年第12期2018-2021,共4页Journal of Practical Radiology

基　　金：重庆市科研院所绩效激励引导专项项目(cstc2017jxjl130011);重庆市卫生和计划生育委员会(西医)重点项目(2016ZDXM027)。

摘　　要：目的评价对比剂分段注射在肝硬化患者肝静脉显影中的价值。方法40例肝硬化患者随机分为2组:对比剂常规注射组(N1)、对比剂分段注射组(N2),每组20例,20例年龄相匹配的非肝硬化患者作为对照组,对比剂剂量1.5 mL/kg,N1组对比剂注射流率为4 mL/s,N2组对比剂采用分段注射,前半剂量注射流率为4 mL/s,后半剂量注射流率为2 mL/s。肝静脉期扫描时间为80 s,测量肝静脉期肝实质、肝静脉的CT值并计算两者差值。结果N1组肝实质、肝静脉CT值及两者差值分别为(96.91±15.32)HU、(126.09±15.56)HU和(26.28±11.24)HU,对照组分别为(106.52±5.53)HU、(153.25±13.47)HU和(49.53±13.45)HU,N2组分别为(98.35±14.46)HU、(141.54±15.31)HU和(41.36±12.26)HU,肝硬化组均明显低于对照组(P<0.05),肝实质的CT值较N1组有一定程度上升,但差别无显著性(P>0.05),肝静脉CT值较N1组显著增加,肝静脉与肝实质CT值差值明显提高(P<0.05)。结论肝硬化患者常规CT增强肝静脉显影困难,对比剂分段注射可以在不增加对比剂总量的前提下提升肝硬化患者肝静脉显影的效果。Objective To explore the clinical application value of contrast agent segmental injection in hepatic vein CT angiography in liver cirrhosis patients.Methods 40 patients with liver cirrhosis were randomly divided into two groups with 20 patients in each group:contrast agent conventional injection group(N1)and contrast agent segmental injection group(N2).20 cases of age-matched patients without liver cirrhosis were served as a control group.The doses of contrast agent were 1.5 mL/kg.The injection rate was 4 mL/s in group N1,while in group N2,the total contrast agent was divided into two parts equally,the first half dose was injected with rate of 4 mL/s,and the rest with injection rate of 2 mL/s.The delay time of scanning was 80 s.The CT values of hepatic parenchyma and hepatic v&n were measured.Results The CT values of liver parenchyma,hepatic vein and the difference-value were(96.91±15.32)HU,(126.09±15.56)HU,(26.28±11.24)HU in group N1,(106.52±5.53)HU,(153.25±13.47)HU,(49.53±13.45)HU in control group,(98.35±14.46)HU,(141.54±15.31)HU,(41.36±12.26)HU in group N2,respectively.The CT values of liver parenchyma and hepatic vein in group N1 and N2 were significantly lower than that of control group(P<0.05).Compared with group N1,the CT values of liver parenchyma increased to a certain extent in group N2,but the difference was not significant(P>0.05),while the difference of CT values between hepatic v&n and liver parenchyma was significantly increased(P<0.05).Conclusion CT venography with contrast agent segmental injection can help to show hepatic vein in patients with cirrhosis without increasing the total amount of contrast agent.

关 键 词：计算机体层成像 肝静脉 肝硬化 血管造影术 

分 类 号：R814.42[医药卫生—影像医学与核医学] R657.31[医药卫生—放射医学]