对比剂浓度对CT小肠成像图像质量影响的应用研究  

Comparing the effect of different concentrations of contrast media in CT enterography

作　　者：刘玉[1] 郭久红 戴晓庆 高维青[1] 丁伟龙[1] 陈娅 闫莹洁 陶晓峰[1] Liu Yu;Guo Jiuhong;Dai Xiaoqing;Gao Weiqing;Ding Weilong;Chen Ya;Yan Yingjie;Tao Xiaofeng(Department of Radiology,Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Bracco Imaging Medical Techologies(Shanghai)Co.,Ltd.,Shanghai 200041,China)

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,200011 [2]博莱科医药科技(上海)有限公司,200041

出　　处：《中华放射学杂志》2020年第5期417-422,共6页Chinese Journal of Radiology

摘　　要：目的探讨不同浓度的对比剂在CT小肠成像中对图像质量的影响。方法前瞻性收集2019年1月至8月上海交通大学医学院附属第九人民医院60例临床需要行CT小肠成像的患者。将患者按照数字表法随机分为3组,每组20例,A组采用400 mg/ml浓度对比剂90 ml,B组采用350 mg/ml浓度对比剂90 ml,C组采用400 mg/ml浓度对比剂79 ml。所有患者均行CT小肠成像检查。观察图像质量,客观评价指标包括主要腹部血管(腹主动脉、肠系膜上动脉、肠系膜下动脉、空肠动脉、回肠动脉、肠系膜上静脉及肠系膜下静脉)、正常空肠、回肠及炎症性肠病(IBD)病灶处肠壁的CT值,计算信噪比(SNR)和对比噪声比(CNR);主观评价指标包括整体图像质量和空回肠直动脉评分。3组患者间计量资料采用单因素方差分析比较。结果3组间各部位平扫的CT值、SNR及CNR值差异均无统计学意义(P>0.05);增强后动脉期A组、C组腹主动脉、肠系膜上动脉、肠系膜下动脉、空肠动脉、回肠动脉的CT值、SNR及CNR高于B组(P<0.05),A组与C组差异无统计学意义(P>0.05);增强后静脉期A组肠系膜上静脉及肠系膜下静脉、空肠、回肠及IBD肠壁的CT值、SNR及CNR高于B组、C组(P<0.05),B组与C组差异无统计学意义(P>0.05)。A、B、C组患者的整体图像质量评分分别为(3.8±0.7)、(3.4±0.6)、(3.4±0.6)分,差异无统计学意义(F=3.075,P=0.054)。3组患者的空回肠直动脉评分分别为(3.5±0.5)、(3.1±0.5)、(3.4±0.5)分,差异有统计学意义(F=3.684,P=0.031)。结论在相同注射流率和扫描参数下,400 mg/ml浓度的对比剂具有更好的血管及空腔脏器增强效果。Objective To explore the enhancement effect of different concentrations of contrast media on blood vessels and hollow organs in CT enterography.Methods Sixty patients with CT enterography were enrolled from January to August 2019 at Shanghai Ninth People's Hospital,and were prospectively randomly divided into three groups(group A:90 ml 400 mg/ml contrast media,group B:90 ml 350 mg/ml contrast media,and group C:79 ml 400 mg/ml contrast media).Evaluation parameters included CT value,signal noise ratio(SNR)and contrast noise ratio(CNR)of main abdominal vessels(abdominal aorta,superior and inferior mesenteric atery,jejunal artery,ileum artery,superior and inferior mesenteric vein),jejunum,ileum and inflammatory bowel disease.The overall image quality and direct jejunum ileum artery quality scores were evaluated.One-way ANOVA was used to compare the parameters among the three groups.Results There was no statistical difference in CT value,SNR and CNR of each measurement index among the three groups in plain scan(P>0.05).The CT value,SNR and CNR of abdominal aorta,superior mesenteric artery,inferior mesenteric artery,jejunal artery and ileal artery in group A and C were higher than those in group B in arterial phase(P<0.05),but there was no significant difference between group A and group C(P>0.05).The CT value,SNR and CNR of superior mesenteric vein,inferior mesenteric vein,normal jejunum,ileum and inflammatory lesions in group A were higher than those in group B and C in venous phase(P<0.05),but there was no significant difference between group B and group C(P>0.05).The overall image quality scores of group A,B and C were(3.8±0.7),(3.4±0.6),(3.4±0.6),respectively,with no significant difference(F=3.075,P=0.054).The direct jejunum ileum artery scores of the three groups were(3.5±0.5),(3.1±0.5),(3.4±0.5),respectively,the difference was statistically significant(F=3.684,P=0.031).Conclusion At the same injection rate and scanning parameters,contrast media at 400 mg/ml can provide better vessel and hollow organ enhanc

关 键 词：造影剂 体层摄影术 X线计算机 小肠造影 图像质量 

分 类 号：R816[医药卫生—放射医学]