华西医学

华西医学

低剂量对比剂联合生理盐水在第二代双源 CT 头颈部 CT 血管成像中的临床应用

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目的探讨低剂量对比剂联合生理盐水在第 2 代双源 CT 头颈部 CT 血管成像(CT angiography,CTA)中的临床应用价值。方法连续纳入 2015 年 3 月—7 月临床怀疑头颈部血管病变的患者 60 例,随机分为 2 组,试验组采用 30 mL 对比剂,对照组采用 50 mL 对比剂。对原始数据进行最大密度投影、曲面重建和容积再现重建,分别测量主动脉弓、颈总动脉分叉处、大脑中动脉 M1 段的 CT 值,由 2 名高年资放射科医师采用双盲法对图像整体质量及静脉污染进行评价。结果所有患者均成功完成头颈部 CTA,两组图像整体质量均满足临床诊断,差异无统计学意义(P>0.05)。试验组的静脉污染轻于对照组(P<0.05)。试验组主动脉弓[(341.3±89.5) HU]、颈总动脉分叉处[(391.0±103.7) HU]、大脑中动脉 M1 段[(305.0±62.0) HU]的 CT 值略小于对照组[(437.3±83.7)、(532.5±113.3)、(396.6±93.1)HU],差异有统计学意义(P<0.05)。结论采用第 2 代双源 CT 行低剂量对比剂头颈部 CTA,在满足临床诊断图像质量的同时,又降低了对比剂使用总量,减轻了静脉污染,具有良好的临床应用价值。

ObjectiveTo explore the clinical value of low-dose contrast agnet in CT angiography (CTA) for head and neck by SOMATOM Definition Flash CT.MethodsSixty consecutive patients with head and neck vessel diseases examined by CTA in the head and neck were chosen from West China Hospital of Sichuan University from March to July 2015, and then were randomly divided into two groups (the experimental group: n=30, 30 mL contrast medium; the control group: n=30, 50 mL contrast medium). Imaging post processing techniques included curved plannar reconstruction, volume rendering, and maximal intensity projection. CT values of the different level of carotid arteries (aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery) were measured. The artifact of the remaining contract in the jugular vein and overall quality of the image were observed by two senior doctors using double blind method.ResultsAll the patients in the two groups completed CTA for head and neck successfully. The image qualities of the two groups satisfid clinical diagnostic requirements, and there was no difference in the image qualities between the two groups (P>0.05). The evaluation of venous pollution in the experimental group was lighter than that in the control group (P<0.05). The CT values of aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery in the experimental group [(341.3±89.5), (391.0±103.7), (305.0±62.0) HU] were slightly lower than those in the control group [(437.3±83.7), (532.5±113.3), (396.6±93.1) HU], which were statistically significant (P<0.05).ConclusionLow-dose contrast in CTA for head and neck by SOMATOM Definition Flash CT can satisfy the clinical diagnostic requirements, and reduce the dose of contrast agent and venous pollution, with a good clinical value.

关键词: 对比剂; 头颈部; 血管造影术; X线计算机,体层摄影术

Key words: Contrast media; Head and neck; Angiography; X-ray computed, tomography

引用本文: 李磊, 赵飞, 夏春潮, 刘露, 李真林. 低剂量对比剂联合生理盐水在第二代双源 CT 头颈部 CT 血管成像中的临床应用. 华西医学, 2018, 33(8): 1015-1018. doi: 10.7507/1002-0179.201608324 复制

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