探究残留钆对比剂对腹部CT图像的影响  

Influence of residual gadolinium contrast agent on abdominal CT images

作　　者：蒋伟[1] 王智慧 陈新吟 洪庆文 袁小平[1] JIANG Wei;WANG Zhi-hui;CHEN Xin-yin;HONG Qing-wen;YUAN Xiao-ping(Department of Radiology,Sun Yat-SenHospital,Sun Yat-SenUniversity,Guangzhou 510000,China)

机构地区：[1]中山大学孙逸仙纪念医院放射科,广州510120

出　　处：《岭南现代临床外科》2021年第3期341-344,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探究残留钆对比剂对腹部CT图像的影响及作用时间,使对患者的影像学检查实现最优化。方法回顾性分析我院135例行上腹部CT检查患者信息,在同一受检者中,有钆对比剂残留的腹部CT图像标记为Ⅰ组;无钆对比剂残留的腹部CT图像标记为Ⅱ组;分别于Ⅰ组及Ⅱ组腹部CT图像的肝区、脾区、胰区、肾区进行三次CT值测量,取其平均值;根据钆对比剂残留时间t对Ⅰ组进行分类,分别为1小时组A(84例)、2小时组B(36例)、3小时组C(13例)、4小时组D(2例),采用配对样本t检验,分析Ⅰ组与Ⅱ组中肝区、脾区、胰区、肾区CT值之间的差异;采用单因素方差分析与秩和检验分析A、B、C、D四小组中肝区、脾区、胰区、肾区CT值与时间之间的关系。结果Ⅱ组与Ⅱ组中肝区、脾区、左肾髓质、左肾盂区、右肾髓质区、右肾盂区CT值之间存在显著性差异,而Ⅰ组与Ⅱ组的胰区CT值无显著性差异;在Ⅰ组中,A、B、C、D四组与时长t不存在相关关系。结论残留的钆对比剂对腹部大部分脏器的CT值有显著性影响,4小时内都无明显衰减,尤其是肾区(肾髓质、肾盂)CT值较对照组有明显的提高,且残留的钆对比剂在CT图像上显示高密度影,直接影响到对病灶的观察,甚至导致漏诊、误诊。因此,不建议行MR增强检查后4时内再进行腹部CT检查,以免影响临床医生及影像医生对患者病情的评估与诊断。Objective To explore the effect of gadolinium contrast agent residue on abdominal CT images and the duration of action,in order to help optimize the imaging examination schedule of patients.Methods First,a set of reasonable and scientifically rigorous screening criteria was established to ensure that the same patient had more than two abdominal CT examinations with and without gadolinium contrast agent residue.Second,by retrospective analysis,200 cases of upper abdominal CT examination were collected from the RIS system of our hospital,and 135 cases were selected according to the screening criteria.Third,in the same client with gadolinium contrast agent residue abdominal CT image tag forⅠgroup,as the experimental group;Without gadolinium contrast agent residue of abdominal CT image tag forⅡgroup,as the control group.Fourth,respectively,in the group ofⅠandⅡabdominal CT image sampling survey,the area of liver,spleen,pancreas,kidney has undergone three CT value measure,take the average.Fifth,according to the gadolinium contrast agent residual time T on subdividingⅠgroup and divided into group A(1 h,84 cases),group B(2 h,36 cases),group C(3 h,13 case)and group D(4 h,2 cases).Sixth,Paired sample T test analysisⅠandⅡgroup of the areas of liver,spleen,pancreas,kidney difference between the CT value;One-way ANOVA and rank-sum tests were used to analyze the relationship between CT value and time T in the areas of liver,spleen,pancreas and kidney in group A,B,C and D.ResultsⅠandⅡgroup in the areas of liver,spleen,left renal medulla and left renal pelvis,right kidney medulla,right renal pelvis that there was a significant difference between CT value andⅠgroup andⅡpancreatic area there was no significant difference between CT value;InⅠgroup.There was no relationship among group A,B,C and D in duration T.Conclusion Residual gadolinium contrast agent for abdomen CT values have a significant effect on most organs,have no obvious attenuation in 4 hours,especially in the kidney area(renal medulla,renal pel

关 键 词：腹部 CT 钆对比剂 

分 类 号：R445.3[医药卫生—影像医学与核医学]