三期双流法在CT肺动脉造影的可行性和安全性评价  

Feasibility and Safety Evaluate of Three Phase Dual Flow Method in Computed Tomographic Pulmonary Angiography

作　　者：薛莉薇 许念洁 刘元芬[1] XUE Liwei;XU Nianjie;LIU Yuanfen(Department of Radiology,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院放射科,福州350001

出　　处：《福建医科大学学报》2024年第4期256-262,共7页Journal of Fujian Medical University

基　　金：福建省科技创新联合资金项目(2018Y9027);福建医科大学附属协和医院重点学科建设经费项目(0256002)。

摘　　要：目的 评价三期双流法在CT肺动脉造影(CTPA)中的可行性和安全性。方法 纳入2022年2—12月可疑肺动脉栓塞患者80例,根据注射对比剂的不同方式分为传统双流组和三期双流组各40例,进行能谱CT扫描。测量或计算2组图像的各级肺动脉、右肺肺静脉和主动脉CT值、肺动脉信噪比和对比噪声比、射束硬化伪影(BHA)指数。采用3分法对图像质量和安全性进行主观评分。比较2组图像的主客观结果。结果 客观评价方面,三期双流组在左肺动脉干、左肺上叶、左肺叶间、左肺下叶、右肺动脉干和右肺下叶基底段动脉CT值均高于传统双流组(P<0.05),其动静脉分离程度、BHA值亦显著优于传统双流组,差别有统计学意义(P<0.05)。主观质量评价方面,三期双流组的平均上腔静脉BHA、动静脉分离均大于传统双流组(P<0.05);主观安全性上,三期双流组的患者主观感受优于传统双流组,差别有统计学意义(P=0.042)。结论 三期双流法CT肺动脉造影在临床上具有良好的可行性和安全性,在CT肺动脉造影中能有效提升动静脉分离效果并减少BHA。Objective To evaluate the safety and feasibility of the three phase dual flow method in computed tomographic pulmonary angiography(CTPA).Methods 80 patients with suspected pulmonary embolisms from February 2022 to December 2022 were included in the study.According to the different injection methods of contrast agents,40 cases were divided into the traditional dual flow group and 40 cases into the three phase dual flow group for energy spectrum CT scanning.Measure the CT values of the pulmonary artery at all levels,right pulmonary vein and aorta,pulmonary artery the signal noise ratio(SNR)and contrast noise ratio(CNR)of pulmonary artery,and beam hardening artifact(BHA)index of two sets of images.Subjectively evaluate image quality and safety using the 3-point method.Compare the subjective and objective results of the two groups.Results In terms of objective evaluation of the results,the CT values of the left pulmonary artery trunk,left upper lobe,left interlobular,left lower lobe,right pulmonary artery trunk,and right lower lobe basal segment artery in the three phase dual flow group were higher than those in the traditional dual flow group(P<0.05),and their degree of arteriovenous separation and BHA values were also significantly better than those in the traditional dual flow group(P<0.05).In terms of subjective quality evaluation,the average upper lumen BHA index in the three phase dual flow group were greater than those in the traditional dual flow group(P<0.05).In terms of subjective safety,the average subjective perception of patients in the three phase dual flow group was better than that in the traditional dual flow group(P=0.042).Conclusion The three phase dual flow CTPA has good feasibility and safety in the clinic and can effectively enhance the efficacy of arteriovenous separation and reduce BHA in CTPA.

关 键 词：CT肺动脉造影 三期双流法 能谱成像 安全性 射束硬化伪影 

分 类 号：R563.5[医药卫生—呼吸系统]