对比剂分段注射在兔肝脏CT血管成像中的价值及方案优化  

The value and optimizing scheme of segmented injection of contrast medium in rabbit liver CT angiography

作　　者：胡勤勤 曾国飞[1] 张昊 刘凤 杨华[1] HU Qinqin;ZENG Guofei;ZHANG Hao;LIU Feng;YANG Hua(Department of Radiology,Chongqing Hospital of Traditional Chinese Medicine,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11期1894-1897,共4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在兔肝脏CT血管成像(CTA)中的价值,并探寻合适的注射方案。方法先后对6只健康大白兔行N1~N44种对比剂注射方案的CT灌注扫描,对比剂总量均为1 mL/kg,N1~N3采用分段注射,先期团注和后期持续注射对比剂剂量比为2:1,N1~N3先期团注和后期持续注射流率比分别为:1:2(0.5 mL/s,1 mL/s),1:1(0.75 mL/s,0.75 mL/s)和2:1(1 mL/s,0.5 mL/s);N4采用一次性注射,注射流率为1 mL/s。分别测量4种方案腹主动脉、门静脉、肝静脉、肝实质的达峰时间和峰值CT值,评价各种方案对肝血管及肝实质的显影效果。结果4种方案中腹主动脉达峰时间及峰值、肝静脉的峰值、门静脉的峰值差异有统计学意义(P<0.05),N1~N33种不同分段注射方式门静脉主干及肝静脉峰值均大于N4,其中N3门静脉及肝静脉峰值最高且峰值持续时间最长,肝脏静脉血管显影质量最佳。结论对比剂分段注射可以在不增加对比剂总量的同时提升门静脉及肝静脉的显影效果,分段注射方案推荐采用先期高流率团注和后期低流率持续注射。Objective To explore the value of segmented inj ection of contrast medium in CT angiography(CTA)of rabbit liver and to explore a suitable inj ection scheme.Methods CT perfusion scan was performed on 6 healthy white rabbits with N1-N44 contrast medium inj ection schemes.The total amount of contrast medium was 1 mL/kg.N1-N3 was for segmented inj ection,the dose ratio of contrast medium for bolus inj ection in the early stage and continuous inj ection in the later stage was 2︰1.The flow rate ratios ofbolus inj ection in the early stage and continuous inj ection in the later stage for N1-N3 were respectively:1︰2(0.5 mL/s,1 mL/s),1︰1(0.75 mL/s,0.75 mL/s)and 2︰1(1 mL/s,0.5 mL/s).N4 was given a single shot at a flow rate of 1 mL/s.The peak time and peak CT value of the abdominal aorta,portal vein,hepatic vein,and liver parenchyma were measured for the four schemes separately;and the imaging effects of these schemes on hepatic blood vessels and liver parenchyma were evaluated.Results There were statistically significant differences in the peak time and peak value of the abdominal aorta,peak value of hepatic vein and portal vein among the four schemes(P<0.05).The peaks of the main portal vein and hepatic veins of the three different inj ection methods of N1-N3 were larger than those of N4.Among them,the portal vein and hepatic vein had the highest peaks and the longest peak duration for N3,and the image quality of hepatic veins was the best.Conclusion Contrast medium segmented inj ection can improve the enhancement effect of the portal vein and hepatic vein without increasing the total amount of contrast medium.It is recomended the use of high flow rate bolus inj ection in the early stage and continuous low flow rate inj ection in the later stage for the scheme of contrast medium segmented inj ection.

关 键 词：肝脏 计算机体层成像 血管造影术 分段注射 兔 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]