双低技术联合个体化注射方案对成人腹部增强CT图像质量的影响及安全性

Effect of double low technology combined with individualized injection on image quality of abdominal enhanced CT in adults and its safety

目的探讨双低技术联合个体化注射方案对成人腹部增强CT的图像质量影响及安全性。方法回顾性分析2019-06至2022-06在无锡市第二人民医院放射科行腹部增强CT检查的231例患者的临床及影像资料,按使用不同碘对比剂分为两组,选取采用等渗对比剂(碘克沙醇270 mgI/ml)的123例为等渗组,采用次高渗对比剂(碘佛醇320 mgI/ml)108例为次高渗组。比较两组临床资料,对图像质量进行主、客观评价,并对CT辐射剂量、CT检查前后肝、肾功能指标进行对比分析。结果等渗组动脉期腹主动脉及门静脉期门静脉的CT值高于次高渗组,差异有统计学意义(P<0.05);等渗组肝脏动静脉期噪声低于次高渗组,差异有统计学意义(P<0.05);两组患者的性别、年龄、身高、体重、辐射剂量差异无统计学意义(P>0.05);两组患者肝脏平扫、动静脉期CT值及强化绝对值、动脉期腹主动脉及门静脉期门静脉噪声、竖脊肌动静脉期CT值、噪声差异均无统计学意义(P>0.05),两组患者腹主动脉、门静脉及门静脉期肝实质信噪比、对比噪声比、肝功能(谷丙转氨酶、谷草转氨酶)、肾功能(尿素氮、血肌酐)差异无统计学意义(P>0.05),两位医师对图像质量主观评估结果一致性极高。结论双低技术联合个体化注射方案的等渗注射进行腹部增强CT可获得更高的动静脉强化程度,图像噪声较低,适宜进行CT后血管重建。

Objective To discuss the effect of double low technology combined with individualized injection on image quality of abdominal enhanced CT in adults and its safety.Methods The clinical and imaging data of 231 patients who underwent abdominal enhanced CT in the Department of Radiology,Wuxi No.2 people's Hospital from June 2019 to June 2022 were retrospectively analyzed.They were divided into two groups according to the use of different iodine contrast agents.123 patients were treated with isotonic contrast medium(iodoxalol 270mgI/ml)as isotonic group,while 108 patients with subhyperosmotic contrast medium(320 mgI/ml)as subhyperosmotic group.The clinical data of the two groups were compared,the image quality was evaluated subjectively and objectively,and the radiation dose of CT and the indexes of liver and kidney function before and after CT were compared and analyzed.Results The CT values of abdominal aorta and portal vein in the isotonic group were significantly higher than those in the subhypertonic group(P<0.05).The hepatic arteriovenous noise in the isotonic group was significantly lower than that in the subhypertonic group(P<0.05).There was no significant difference in sex,age,height,weight or radiation dose between the two groups(P>0.05).There was no significant difference in liver plain scan,arteriovenous phase CT value and absolute enhancement value,arterial phase abdominal aorta and portal vein phase portal vein noise,vertical spinal muscle arteriovenous phase CT value or noise between the two groups(P>0.05).There was no significant difference in signal-to-noise ratio,contrast-to-noise ratio,liver function(glutamic pyruvic transaminase,glutamic oxaloacetic transaminase),or renal function(urea nitrogen,serum creatinine)between the two groups(P>0.05).The subjective evaluation results of image quality were highly consistent between the doctors.Conclusions The iso-osmotic injection of double-low technique combined with individualized injection for abdominal enhanced CT can obtain higher degree of arteriovenous enhancement and lower image noise,so it is suitable for vascular reconstruction after CT.