Wide-Volume技术在颈动脉血管成像中的应用与价值

Application and Value of Wide-Volume Technique in CT Angiography of the Neck

目的探讨佳能医疗320排CT在颈动脉CT血管造影(CTA)中使用多容积扫描技术(Wide-Volume)和常规扫描技术之间图像质量和辐射剂量上的差异。方法搜集本院122例临床怀疑颈动脉疾病且行CTA检查的患者,随机分成A、B两组。A组使用双监测颈部C4水平处当其中任意一侧颈动脉CT值到达设定阈值后触发行两次Wide-Volume技术扫描。B组监测升主动脉,当到达阈值后行常规螺旋扫描。分别测量两组图像颈动脉(包括颈总动脉、颈内/外动脉)、椎动脉、基底动脉、上腔静脉、头臂干、锁骨下静脉及颈静脉的CT值,由两名经验丰富的放射科医师对两组图像的质量及辐射剂量进行评价和统计学分析。结果两组颈总动脉开口处;左、右颈内动脉(颈动脉窦上2 cm)、基底动脉的CT值比较差异无统计学意义(P>0.05)。两组头臂干、右锁骨下静脉、上腔静脉和两侧颈静脉开口处CT值比较差异有统计学意义(P<0.001)。A组的图像主观质量评分要高于B组。在患者辐射剂量上,A组较B组有显著降低(P<0.001)。结论Wide-Volume技术可以减少颈部的静脉污染提高图像质量,并大幅度降低患者的辐射剂量,具有较高的临床应用价值。

Objective To investigate the difference in image quality and radiation dose between Canon 320-channel CT in the use of Wide-volume scanning(Wide-Volume)and conventional scanning techniques in carotid CTA.Methods A total of 122 patients with clinically suspected carotid artery disease who underwent CTA were randomly divided into groups A and B.Group A uses a Region Of Interest neck at the fourth vertebral body level to trigger a two-volume scan when any one of them reaches a set threshold.Group B monitors the ascending aorta and performs a standard helical scan when the threshold is reached.CT values of carotid arteries(including common carotid artery,internal/external/external artery),vertebral artery,basilar artery,superior vena cava,brachiocephalic trunk,subclavian vein and jugular vein were measured in two groups,respectively.The physician evaluated and statistically analyzed the quality and radiation dose of the two groups of images.Results There were no significant differences in the CT values between the left and right internal carotid arteries(2 cm above the sinus)and the basilar artery(P>0.05).There were significant differences in CT values between the right and left brachial veins,the right subclavian vein,the superior vena cava,and the jugular vein openings(P<0.001).The subjective quality score of the images in group A was higher than that in group B.In the patient radiation dose,group A was significantly lower than group B(P<0.001).Conclusion Wide-Volume scanning technology can reduce the venous contamination of the neck,improve the image quality,and greatly reduce the radiation dose of patients,which has high clinical application value.