基于体表面积调节的低浓度对比剂个体化注射方案在冠状动脉支架CTA中的应用  

The application value of individualized low dose contrast agent injection scheme in coronary stent CTA based on body surface area

作　　者：荣梅[1] 李彩辉 闫建华 赵启利[1] 李兆祥[1] RONG Mei;LI Caihui;YAN Jianhua(People’s Hospital of Langfang City,Hebei,Langfang 065000,China)

机构地区：[1]河北省廊坊市人民医院放射科,065000

出　　处：《河北医药》2021年第2期214-218,共5页Hebei Medical Journal

基　　金：廊坊市科学技术研究与发展计划项目(编号:2014013008C)。

摘　　要：目的探讨基于体表面积(BSA)调节的低浓度对比剂个体化注射方案在冠状动脉支架CTA(CSCTA)中的应用价值。方法前瞻性连续入选2014年10月至2018年10月冠脉支架CTA随访门诊患者80例,并随机分成A、B组,每组40例,A组用等渗低浓度对比剂威视派克(270 mgI/ml),注射流率为2.4 ml·s-1·m-2×BSA(m2);B组用高浓度对比剂欧乃派克(350 mgI/ml),注射流率为5 ml/s,2组均采用常规剂量(120 Kvp)扫描。比较2组主动脉根部CT值、噪声值(SD),图像信噪比(SNR),比噪声比(CNR),图像质量评分,注射流率,碘流率,注射时间,对比剂总量及碘摄入量。结果共检出101枚冠脉支架,其中97枚支架可评价(A组53枚,B组48枚)。A、B2组的SD、SNR、CNR和图像质量评分、注射时间差异无统计学意义(P>0.05)。4组主动脉根部CT值、碘流率、对比剂总量及碘摄入量注射流率均明显低于B组差异有统计学意义(P<0.05)。结论在冠状动脉支架CTA检查中,在保证图像质量前提下,BSA调节的低浓度对比剂个体化注射方案能明显降低碘流率及对比剂有效碘用量,因此可以减少对比剂肾病等不良反应的发生率,具有较好的临床应用价值。Objective To investigate the application value of individualized low dose contrast agent injection scheme in coronary stent CTA(CSCTA)based on body surface area.Methods A total of 80 outpatients who underwent coronarystent CTA in our hospital from October 2014 to October 2018 were enrolled in the study,who were randomly divided into group A and group B,with 40 cases in each group.The patientts in group A were scanned by using Iodixanol(270 mgI/ml)with injection speeds of 2.4ml·s-1·m-2×BSA(m2),however,the patients in group B were scanned by using omnipaque(350mgI/ml)with injection speeds of 5ml/s.The patients in both groups were examined by using 120kVp.The aorta root’s CT value,noise value(SD),image signal-to-noise ratio(SNR),comparison noise ratio(CNR),image quality score,injection speeds,iodine flow rate,injection time,total amount of contrast medium,and the iodine intake amount were observed and compared between the two groups.Results A total of 101 coronary stents were detected,in which,97 were evaluable(53 stents in group A and 48 stents in group B).There were not significant differences in SD,SNR,CNR,scores of the image quality and injection time between the two groups(P>0.05).Moreover of the aorta root’s CT value,iodine flow rate,total amount of contrast medium and iodine intake amount in group A were significantly lower than those in group B(P<0.05).Conclusion During CSCTA examination,under guaranteeing the quality of image,the individualized low dose contrast agent injection scheme based on body surface area can significantly reduce the iodine flow rate and the effective iodine contrast agent dosage,which can decrease the incidence of adverse reactions including contrast-induced nephropathy,therefor,it is valuable in clinical practice.

关 键 词：640层螺旋CT 体表面积 碘流率 低浓度对比剂 冠状动脉支架CTA 

分 类 号：R541.4[医药卫生—心血管疾病]