基于肝脏体积测量计算腹部CT增强扫描碘对比剂剂量个体化方案的可行性  

A feasibility study on calculating individualized scheme of dose of iodine contrast medium in enhanced abdominal CT imaging based on liver volume measurement

作　　者：宋巍[1] 吕梁[1] 刘兴利 王罡[1] 李治[1] 杨净松 汪志华[1] Song Wei;Lyu Liang;Liu Xingli;Wang Gang;Li Zhi;Yang Jingsong;Wang Zhihua(Department of Radiology,First People's Hospital of Yunnan Province,the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650031,China)

机构地区：[1]云南省第一人民医院昆明理工大学附属昆华医院放射科,650031

出　　处：《中华放射学杂志》2020年第5期403-407,共5页Chinese Journal of Radiology

基　　金：云南省卫生科技计划(2018NS0269)。

摘　　要：目的探讨基于肝脏体积(LV)测量计算腹部CT增强扫描碘对比剂个体化方案的可行性和价值。方法回顾性分析2019年2月至9月云南省第一人民医院接受腹部三期CT增强扫描,并按体表面积计算对比剂用量的64例患者。测量LV、平扫肝实质密度、增强扫描肝实质密度、肝实质平均碘含量(AII),计算增强密度强化差值(ΔHU)、对比剂注射总碘量(IM),并计算肝实质内碘总量(TII)。采用Pearson相关分析评价AII与ΔHU以及IM与TII的相关性,并获取回归方程。根据回归方程推导出对比剂注射量预测方程后,将对比剂预测值与实际对比剂注射剂量采用配对t检验进行比较。结果AII与ΔHU以及IM与TII均呈正相关,r值分别为0.926、0.759,P均<0.05,回归方程分别为YAII=0.034XΔHU+0.296、YIM=3.649XTII+16486.754。参照肝实质增强扫描强化值ΔHU=50 HU为基准,推导基于LV计算个体化对比剂注射剂量总碘量为YIM=7.225XLV+16486.754,将公式引入全部患者计算对比剂应用预测值,计算所得对比剂注射量为(64.27±4.92)ml,将对比剂预测注射量与实际注射量进行比较,二者差异有统计学意义(t=6.009,P<0.05),且对比剂注射量预测量较当前实际注射量减低。结论基于LV测量计算腹部CT增强扫描对比剂个体化用量的方案具有可行性,可以预测肝实质在增强扫描中的强化水平,并可减低碘对比剂的使用量。Objective To explore the feasibility and value of individualized scheme of dose of iodine contrast medium in enhanced abdominal CT imaging based on liver volume(LV)measurement.Methods The examination data and technical parameters of 64 patients,who underwent multi-phase dynamic enhanced abdominal CT imaging from February to September 2019 at First People's Hospital of Yunnan Province were retrospectively analyzed.The density of liver on CT pre-contrast images and post-contrast images,LV and average iodine content in the liver(AII)of all subjects were measured.The difference of liver density(ΔHU),total iodine dose of contrast agent injected(IM)and total intrahepatic iodine(TII)were calculated.Pearson correlation analysis was performed to evaluate the association between AII andΔHU,as well as IM and TII.The difference between the injection volume of contrast agent predicted by the formula and the actual injection volume of contrast agent was tested by paired t test.Results TheΔHU and AII showed highly positive correlation(r=0.926,P<0.05).The regression equation was YAII=0.034XΔHU+0.296.The TII showed significantly positive correlation with the IM(r=0.759,P<0.05),and the regression equation was YIM=3.649XTII+16486.754.With the liver enhancementΔHU=50 HU as a reference,the individually dose of contrast medium injection could be deducted based on LV,with YIM=7.225XLV+16486.754.This formula was introduced into all the subjects to calculate the predicted value of contrast agent application,and the calculated injection volume of contrast agent was(64.27±4.92)ml.Paired t test was conducted to compare the predicted injection volume of contrast agent with the actual injection volume of contrast agent,and the difference was statistically significant(t=6.009,P<0.05).Conclusion The feasibility of calculating individualized scheme of contrast agent based on LV in enhanced abdominal imaging is verified.This method can be used to predict the enhancement level of liver and to reduce the dosage of iodine contrast agent.

关 键 词：肝 体层摄影术 X线计算机 造影剂 

分 类 号：R816[医药卫生—放射医学] R57[医药卫生—临床医学]