双流法肺动脉技术在肺动脉扫描中的应用评价  

Assessment of double-flow method in CT pulmonary angiography

作　　者：杨文杰 梁烨 杨柯[2] YANG Wenjie;LIANG Ye;YANG Ke(Department of Medical Imaging,Maternal and Child Health Hospital of Hubei Province,Hubei 430070,China)

机构地区：[1]湖北省妇幼保健院医学影像科,湖北武汉430070 [2]湖北省天门市第一人民医院CT、MR室,湖北天门431700

出　　处：《影像诊断与介入放射学》2024年第4期278-282,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨双流法(通过在注射对比剂之前将生理盐水和对比剂混合并部分代替对比剂而实现人体内差异化显影的CT血管成像)在128排螺旋CT肺动脉成像中的应用价值。方法选取2022年1月—2024年3月在天门市第一人民医院接受检查的临床诊断为疑似肺动脉栓塞的患者40例,随机将其分成监测法扫描组(对照组)和双流法扫描组(实验组)各20例。两组均使用Philips 128排螺旋CT,对照组兴趣区设上腔静脉,阈值150 HU,不间断注射50 mL的碘比醇(350 mg I/mL)、30 mL生理盐水;实验组兴趣区设肺动脉干,阈值设60 HU,不间断注射对比剂和生理盐水的混合液22 mL(对比剂为6 mL,生理盐水为16 mL)、20 mL混合液(对比剂为17 mL,生理盐水为3 mL)、30 mL生理盐水。测量两组图像肺动脉干CT值、肺静脉CT值以及上腔静脉CT值,比较分析上述两组所得图像质量。结果实验组肺动脉干CT值(360.1±48.09)HU、肺静脉CT值(154.25±45.97)HU与对照组肺动脉干CT值(371.35±60.16)HU、对照组肺静脉CT值(153.8±30.29)HU相比无统计学差异(t=-2.16、-1.168,P>0.05),实验组上腔静脉CT值(198.5±55.97)HU显著低于对照组上腔静脉CT值(1001.25±299.55)HU,差异有统计学意义(t=-8.048,P<0.05)。实验组肺动脉主观评分与对照组无统计学差异(P=0.085),实验组上腔静脉伪影主观评分显著高于对照组(P=0.000)。结论与对照组相比,采用双流法肺动脉CT血管成像的上腔静脉污染更小,碘对比剂用量更少,能满足诊断需求,在临床检查中更具有推广使用的价值。Objective To explore the application value of double-flow method of CT angiography using a mixture of normal saline and contrast agent before injection of contrast agent to achieve differential imaging within the human body in CT pulmonary angiography(CTPA).Methods Forty patients with clinically suspected pulmonary embolism at our hospital from January 2022 to March 2024 were randomly divided into monitoring scanning control group(20)and dual-flow scanning study group(20)for CTPA using Philips 128-row spiral CT.In the control group,region of interest(ROI)was placed in the superior vena cava(SVC)with a threshold of 150 HU,50 mL iobitridol(350 mg I/mL)and 30 mL normal saline were continuously injected.In the experimental group,ROI was placed in the pulmonary trunk(PT)with a threshold of 60 HU,6 mL of contrast agent and 16 mL of normal saline mixture,17 mL of contrast agent and 3 mL of normal saline mixture,and 30 mL of normal saline solution were continuously injected.The CT values of PT,pulmonary vein(PV)and SVC of the two groups were measured and the image quality was compared.Results There was no significant difference(t=-2.16,-1.168;P>0.05)between the CT values of PT(371.35±60.16)and PV(153.8±30.29)in the control group and that of the experimental group(360.1±48.09,154.25±45.97).These numbers are the same for both groups.The SVC CT value of the study group(198.5±55.97)was significantly lower(t=-8.048,P<0.05)than that of the control group(1001.25±299.55).There was no significant difference in pulmonary artery subjective scores between the experimental group and the control group(P=0.085).The subjective score of superior vena cava artifact in the experimental group was significantly higher than that in the control group(P=0.000).Conclusion Double-flow CTPA uses less contrast agent with decreased enhancement of SVC and better PT image quality.

关 键 词：双流法 体层摄影术 X线计算机 肺动脉栓塞 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563.5[医药卫生—放射医学]