两段式对比剂注射结合团注跟踪技术在肺动脉CTA检查中的应用研究  

Study of Two-stage Injection of Contrast Agent in Combination with Bolus Tracking Technique in Computed Tomography Pulmonary Angiography

作　　者：刘云福[1] 康天良[1] 张永县[1] 李伟[1] 许庆刚[1] 王新艳[1] 鲜军舫[1] 牛延涛[1] LIU Yunfu;KANG Tianliang;ZHANG Yongxian;LI Wei;XU Qinggang;WANG Xinyan;XIAN Junfang;NIU Yantao(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730

出　　处：《CT理论与应用研究（中英文）》2023年第4期531-538,共8页Computerized Tomography Theory and Applications

基　　金：北京市医院管理局临床医学发展专项(眼耳鼻喉影像(ZYLX201704));北京市医院管理中心“登峰”计划专项(DFL20190203)。

摘　　要：目的:探讨两段式对比剂注射结合团注跟踪技术在肺动脉CTA成像中的应用价值。方法:收集2022年7月至12月在首都医科大学附属北京同仁医院因怀疑肺栓塞行肺动脉CT增强检查的30例患者为试验组,使用两段式对比剂注射结合团注跟踪技术的方法。兴趣区(ROI)置于肺动脉主干,设定阈值为100 HU。对比剂和生理盐水注射顺序:(1)对比剂10 mL;(2)生理盐水30 mL;(3)对比剂20 mL;(4)生理盐水30 mL,注射流率均为5 mL/s。跟踪肺动脉主干CT值,达到设定阈值后延迟10 s开始扫描。收集2021年1月至2021年12月间30例患者为对照组,采用小剂量团注测试技术。先注射对比剂10 mL+生理盐水30 mL测量肺动脉主干达峰时间,再注射对比剂20 mL+生理盐水30 mL,以达峰时间+1 s作为延迟时间扫描。测量两组图像肺动脉、肺静脉、锁骨下静脉、升主动脉的CT值,并对两组图像肺动脉图像质量和上腔静脉硬化伪影进行评分。两组图像血管CT值的比较采用独立样本t检验;肺动脉图像质量评分、上腔静脉硬化伪影评分的比较采用非参数Mann-Whitney U检验。结果:试验组左肺动脉、右肺上叶动脉、右肺中叶动脉、右肺下叶动脉、左肺上叶动脉、升主动脉CT值大于对照组,差异有统计学意义;试验组和对照组肺动脉主干、右肺动脉、左肺下叶动脉、右上肺静脉、右下肺静脉、左上肺静脉、左下肺静脉、锁骨下静脉、右侧动静脉CT值差值、左侧动静脉CT值差值差异无统计学意义;试验组和对照组肺动脉影像质量评分差异无统计学意义;试验组和对照组上腔静脉硬化伪影评分差异无统计学意义。结论:肺动脉CTA检查使用两段式对比剂注射结合团注跟踪技术可获得稳定的图像质量,且操作步骤简单易行,过渡延迟时间适用于大多数CT设备,值得在临床推广。Objective:To investigate the utility of a two-stage injection of contrast agent combined with a bolus tracking technique in computed tomography(CT)pulmonary angiography.Methods:We recruited 30 patients undergoing CT pulmonary angiography due to suspected pulmonary embolism at Beijing Tongren Hospital affiliated to Capital Medical University from February to April 2022 as the experimental group,using a two-stage injection of contrast agent combined with bolus tracking technique.The region of interest(ROI)was placed in the pulmonary trunk with a threshold of 100HU.Contrast agent and normal saline injection sequence:(1)contrast agent 10 mL;(2)normal saline 30 mL;(3)contrast agent 20 mL;(4)normal saline 30 mL;the injection rate for all was 5 mL/s.The CT value of the pulmonary trunk was tracked,and scanning was delayed for 10 s after reaching the set threshold.Using the test bolus technique,we recruited 30 patients from January to December 2021 as the control group.First,10 mL of contrast plus 30 mL of normal saline was injected to measure the peak time of the main pulmonary artery.Then,20 mL of contrast plus 30 mL of normal saline was injected,and the peak time+1 s was used as the delay time for the scan.CT values were measured for the pulmonary artery,pulmonary vein,subclavian vein,and ascending aorta in both groups.Both groups scored the quality of the pulmonary artery images and the sclerotic artifacts of the superior vena cava.We compared the CT values of the vessels in the two groups using independent sample t-tests.We compared the pulmonary artery image quality scores and the sclerotic artifact scores of the superior vena cava using a nonparametric Mann–Whitney U-test.Results:CT values of the left pulmonary artery,right upper lobe artery,right middle lobe artery,right lower lobe artery,left upper lobe artery,and ascending aorta of the experimental group were higher than those of the control group,and the difference was statistically significant.There was no significant difference in the main pulmonary artery,

关 键 词：体层摄影术 X线计算机 肺动脉 对比剂 

分 类 号：R814[医药卫生—影像医学与核医学]