基于对比剂分段注射的颈髓双期CT血管成像  

Dual-phase CT angiography imaging of cervical cord based on segmented injection of contrast medium

作　　者：胡勤勤 张德川 曾国飞[1] 杨华[1] HU Qinqin;ZHANG Dechuan;ZENG Guofei;YANG Hua(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》2021年第5期716-719,723,共5页Journal of Practical Radiology

基　　金：重庆市卫生和计划生育委员会(西医)重点项目(2016ZDXM027).

摘　　要：目的探讨对比剂分段注射颈髓双期CT血管成像(CTA)检查在颈髓血管中的应用价值.方法对30例临床怀疑脊髓型颈椎病拟行头颈部CTA检查的患者进行对比剂分段注射颈髓双期CTA检查(A组),先期团注流率为4mL/s,后期以2mL/s的低流率持续注射,先期团注和后期低流率持续注射对比剂剂量的比率为3︰1,采用常规峰值(P_(1))期和延迟平衡(P_(2))期双期扫描,P_(2)期扫描时间为峰值期扫描结束后再延迟5s.选取性别、年龄相匹配的临床怀疑脑缺血拟行头颈部CTA检查的30例患者作为对照组(B组),B组对比剂一次性注射,注射流率为4mL/s,采用常规CTA峰值期扫描.注射对比剂为碘帕醇(370mgI/mL),对比剂总量为1.5mL/kg.对A、B组图像的脊髓前动脉(ASA)及前根动脉(ARA)的显示情况进行评分,对比P_(1)期、P_(2)期及B组图像ASA的CT值及其信噪比(SNR)、对比噪声比(CNR)值.结果A组P_(2)期图像的主观评分高于P_(1)期和B组,差异有统计学意义(P<0.05),A组P_(1)期及B组ASA的显示率分别为50.0%和53.3%,A组P_(2)期ASA的显示率为86.7%;P_(1)期及P_(2)期共同的显示率可达90%.P_(1)期、P_(2)期和B组ARA显示的例数和支数分别为:22例、48支,27例、106支和23例、50支,P_(2)期图像ASA及ARA的显示明显优于P_(1)期和B组.3组ASACT值及其SNR、CNR值差异有统计学意义(P<0.05),P_(2)期图像优于P_(1)期及B组图像.结论对比剂分段注射颈髓双期CTA能显著提高ASA及ARA显影质量,可以作为具有复杂血管网器官的补充CTA方法.Objective To explore the application value of segmented injection of contrast medium in dual-phase CTA imaging of cervical cord vessel.Methods Group A:30 patients with clinically suspected cervical spondylotic myelopathy scheduled to undergo head and neck CTA imaging were examined by segmented injection of contrast medium into the cervical cord.The flow rate of bolus injection at early stage was 4 mL/s,and that of low flow rate continuous injection at late stage was 2 mL/s,with the ratio of contrast medium dose(bolus injection at early stage:bolus injection at late stage)of 3∶1.Routine peak(P_(1))phase and delayed balance(P_(2))phase dual-phase scan was used,and the scan time of P_(2)phase was delayed for 5 s after the end of peak scan.Group B:30 patients with suspected cerebral ischemia who were clinically suspected to be examined by head and neck CTA were selected as the control group.They were injected with contrast medium once at a flow rate of 4 mL/s.Routine CTA peak scan was used.The contrast medium was iopamidol(the concentration of iodine was 370 mg I/mL)and the total amount of contrast medium was 1.5 mL/kg.The anterior spinal artery(ASA)and anterior radicular artery(ARA)in group A and B were scored,and the CT valucs,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of ASA in images of P_(1),P_(2) and group B were compared.ResultsThe subjective score of P_(1) image in group A was higher than that in P_(2) and group B,and the difference was statistically significant(P<0.05).The ASA display rate in P_(2) of group A and group B was 50.0%and 53.3%,respectively.The ASA display rate of P_(1)of group A was 86.7%.The commondisplay rate of P_(1)and P_(2)was 90%.The case number and vessel number of ARA in P.,P。and group B were(22 cases,48 vessels),(27 cases,106 vessels),(23 cases,50 vessels),respectively.The ASA display and ARA in P_(2)were significantly better than those in P_(1) and group B.There were significant dfferences in CT values,SNR and CNR values of ASA among the three groups(P<0.05).The imag

关 键 词：颈髓 计算机体层成像 血管造影术 对比剂分段注射 双期扫描 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]