基于小剂量团注测试结果在肺动脉血管成像中对比剂用量的精准计算  

Accurate calculation of contrast agent dosage in CT pulmonary angiography based on small-dose bolus test results

作　　者：何竹 郑君惠[1] 何兰[1] HE Zhu;ZHENG Junhui;HE Lan(Department of Radiology,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Guangzhou 510080,P.R.China)

机构地区：[1]广东省人民医院(广东省医学科学院)放射科,广东广州510080

出　　处：《医学影像学杂志》2021年第9期1484-1488,共5页Journal of Medical Imaging

基　　金：广东省医学科学技术研究基金项目(编号:A2017232)。

摘　　要：目的探讨小剂量团注测试结果计算肺动脉血管成像(CTPA)对比剂用量,并评价该对比剂用量下CTPA的影像质量。方法前瞻性分析100例临床怀疑肺栓塞(pulmonary embolism,PE)的患者,随机分为两组,均采用小剂量团注测试法,测试肺动脉主干峰值时间T 1和左心房峰值平台末时间T 2,测试对比剂10 ml和生理盐水30 ml,注射流速4 ml/s。常规组对比剂用量固定50 ml,试验组对比剂用量〔(T 2-扫描时间)×4-12〕ml。其余扫描参数一致。采用SPSS 17.0统计学软件分析两组肺动脉主干、上腔静脉、主肺静脉、左心房的CT值,对比剂用量及肺动脉相关血管图像质量是否具有统计学差异。结果两组肺动脉主干、主肺静脉、左心房CT值差异无统计学意义(P>0.05);两组上腔静脉CT值及肺动脉相关血管图像质量评分差异有统计学意义(P<0.05);试验组对比剂用量(33.86±5.81)ml与常规组50 ml差异有统计学意义(P<0.05)。结论基于小剂量团注测试结果计算CTPA对比剂用量与常规组比较,对比剂用量明显减少,肺动脉图像质量占优,且明显减少上腔静脉硬化伪影,减少对比剂肾病(CIN)的发生,值得临床推广使用。Objective To explore the results of small-dose bolus test to calculate the amount of contrast agent of CT pulmonary arterial angiography(CTPA),and to evaluate the image quality of CTPA under the amount of contrast agent.Methods A prospective analysis was conducted on 100 patients with clinically suspected pulmonary embolism,who were randomly divided into two groups.All patients were tested with a low-dose bolus test to test the peak time T 1 of the main pulmonary artery and the end time T 2 of the peak left atrial plateau.30 ml of normal saline was injected at a flow rate of 4 ml/s.The amount of contrast agent in the conventional group was fixed at 50 ml,and the amount of contrast agent in the test group was〔(T 2-scan time)×4-12〕ml.The remaining scanning parameters was consistent.The SPSS 17.0 statistical software was used to analyze whether the CT values of the main pulmonary artery,superior vena cava,main pulmonary vein,and left atrium of the two groups was statistically analyzed.Results There were no significant differences in CT values of pulmonary arterial trunk,main pulmonary veins,and left atrium between the two groups(P>0.05).There was a significant difference in CT value of superior vena cava and image quality scores of pulmonary arteries related blood vessels between the two groups(P<0.05).The contrast agent dosage in the group was(33.86±5.810)ml and the difference between the conventional group and 50 ml was statistically significant(P<0.05).Conclusion Based on the results of the small-dose bolus test,compared with the conventional group,the amount of CTPA contrast agent is significantly reduced,the pulmonary artery image quality is superior,the superior vena cava sclerosis artifacts are significantly reduced,and the incidence of contrast nephropathy(CIN)is reduced,which is worth of worth clinical promotion.

关 键 词：肺动脉 肺栓塞 小剂量团注测试 体层摄影术 X线计算机 对比剂 

分 类 号：R814.41[医药卫生—影像医学与核医学] R543.2[医药卫生—放射医学]