头足方向CT血管成像在下肢深静脉血栓合并肺动脉栓塞患者的应用价值  

Clinical value of one-step CT angiography from deep vein of lower limbs to pulmonary artery in the direction of head and foot

作　　者：梁其洲[1] 陈晶[1] 黄丹妮[1] 高峰[1] 黄良皓 张武 邬玉芹 陈红 符水喜 Liang Qizhou;Chen Jing;Huang Danni;Gao Feng;Huang Lianghao;Zhang Wu;Wu Yuqin;Chen Hong;Fu Shuixi(Department of Radiology,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou 570208,China;Department of Radiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Radiology,the First Hospital of Changsha,Changsha 410005,China)

机构地区：[1]中南大学湘雅医学院附属海口医院放射科,海口570208 [2]中山大学附属第三医院放射科,广州510630 [3]长沙市第一医院放射科,长沙410005

出　　处：《中华放射学杂志》2022年第12期1371-1375,共5页Chinese Journal of Radiology

摘　　要：目的探究头足方向下肢深静脉至肺动脉一站式CT血管成像的临床应用价值。方法收集2017年1月至2019年6月就诊于中南大学湘雅医学院附属海口医院的28例下肢深静脉血栓合并肺动脉栓塞患者,所有患者均行一站式下肢深静脉至肺动脉CT血管成像,简单随机法分为A(12例)、B(16例)两组,扫描范围均为胸廓入口至膝关节下方10 cm处。A组为足头方向组,根据经验法延迟时间扫描;B组为头足方向组,以肺动脉主干层面的单点触发自动追踪扫描。采用独立样本t检验比较两组的扫描时间、剂量长度乘积(DLP)和肺动脉开口的强化平均CT值。结果足头方向组的扫描时间为(36.4±1.2)s,DLP为(684.4±37.8)mGy·cm,肺动脉层面图像的强化CT值为(181.3±15.5)HU。头足方向组的扫描时间为(16.4±0.3)s,DLP为(441.8±34.4)mGy·cm,肺动脉层面图像的强化CT值为(257.9±24.5)HU。两组方法的扫描时间、DLP和肺动脉层面强化值差异均有统计学意义(t值分别为17.92、4.71、2.44,P<0.05)。结论头足方向一站式下肢深静脉至肺动脉CT血管成像临床应用价值优于足头方向扫描,能够显著缩短扫描时间,降低辐射剂量,增加肺动脉强化值以提高肺动脉栓塞的检出。Objective To explore the clinical value of one-step CT angiography from deep vein of lower limbs to pulmonary artery in the direction of head and foot.Methods Twenty-eight patients who presented Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2017 to June 2019 were collected.All patients who underwent one-step CT angiography of the deep veins of the lower extremities to the pulmonary artery were randomly divided into two groups,A or B,and scanned from the entrance of the thorax to 10 cm below the knee joint.Group A was foot-head direction group with delayed time scanning according to empirical method.Group B was the head-foot direction group with a single point triggered automatic tracing scan at the level of the main pulmonary artery trunk.The independent sample t-test was used to compare the scan time,dose length product(DLP),and mean CT value of enhancement of the pulmonary artery opening between the two groups.Results The average scanning time of the foot-head scanning group was(36.4±1.2)s,the average DLP was(684.4±37.8)mGy·cm,and the average enhanced CT value of pulmonary artery image was(181.3±15.5)HU.The average scanning time of the head foot scanning group was(16.4±0.3)s,the average DLP was(441.8±34.4)mGy·cm,and the average enhanced CT value of the pulmonary artery image was(257.9±24.5)HU.Scanning time,mean DLP,and pulmonary artery level enhancement values were significantly different between the two groups(t=17.92,4.71,2.44,P<0.05).Conclusions The clinical value of one-step CT angiography from deep vein of lower limbs to pulmonary artery in the head-foot direction is significantly better than that in the head-foot direction.It can significantly shorten the scanning time,reduce the radiation dose,and increase the enhancement value of pulmonary artery to improve the detection of pulmonary embolism.

关 键 词：体层摄影术 X线计算机 下肢深静脉血栓 肺栓塞 

分 类 号：R543.6[医药卫生—心血管疾病] R563.5[医药卫生—内科学]