16层CT头颈动脉成像优化方案

Application of reconstruction technique of multi-slice CT to brain and neck CTA

目的 研究16层螺旋CT血管造影在头颈部血管成像的最优对比扫描方案及相关参数优选.方法 收集80例临床怀疑颈部血管病变的患者,随机分为常规扫描方案组(A)和优化方案组(B),每组各40例,所有扫描数据均进行横断面、MPR、MIP、SSD重建,分析各组上腔静脉的强化程度、条状伪影、血流相关伪影和总体成像质量,选择最优的对比剂注射方案.结果 80例受检者均顺利完成CT增强扫描.B组方案的上腔静脉强化程度、条状伪影及总体图像质量均优于其他方案(P<0.05),获得了优质的横断面及三维重建图像,仅在血流相关伪影方面略次于A组,但差异无统计学意义(P>0.05).但B组有1例的主动脉强化较差达不到三维重建的要求.结论 经肘前静脉以4 ml/s 速度同时注射碘浓度为90 g/L 对比剂,延迟25～28 s 开始扫描是最理想的对比剂注射方案.

Objective To investigate the optimized strategy of brain and neck computerized tomographic angiography(CTA) in clinical practice.Methods In the retrospective study,80 patients suspicious of neck vascular diseases who had undergone brain and neck CTA were randomized into conventional imaging group and optimized imaging group(n=40/group).All the imaging data were analyzed by reconstruction of MPR,MIP and SSD.Results Compared with the conventional imaging group,the injected side brachiocephalic vein shadow interference and the intracranial vein CT values were obviously decreased in the optimized imaging group(P<0.05) while the imaging quality of the distal segment of vertebral artery was not changed(P>0.05).Conclusion Optimized strategy of brain and neck CTA using multidetector computerized tomography(MDCT) can effectively eliminate the interference of contrast agent,decrease the intracranial vein imaging and improved the imaging quality of common carotid artery and initial segment of vertebral artery.