多排螺旋CT腹部增强扫描中使用盐水冲刷对比剂技术的评价

Valuation of using saline flush technique of contrast medium on abdominal multidetector row CT scanning

目的比较不同量的对比剂追加盐水后,在腹部增强扫描中对各脏器和血管的影响程度,以期达到不影响强化、减少副作用且减少造影剂用量的目的。方法75例受检者分为3组,A组单独注射对比剂100ml组,B组注射对比剂80ml追加生理盐水20ml组和C组注射对比剂70ml追加生理盐水30ml组。在常规扫描的动脉期33s和门脉期80s进行数据采集。测量肝脏、脾脏、胰腺、肾脏门脉主干、主动脉及下腔静脉的CT值,比较三组间的不同。结果脾脏门脉期、胰腺门脉期、肾脏门脉期、门静脉门脉期和主动脉门脉期在三组间均有统计学差异,进行两两比较结果表明脾脏门脉期、胰腺门脉期、肾脏门脉期、门静脉门脉期和主动脉门脉期在A和C组间有统计学差异,而胰腺门脉期和肾脏门脉期仅在A和B组间无统计学差异。结论腹部MDCT扫描中,使用对比剂追加盐水冲刷技术,可减少对比剂的用量,减少肾毒性,对临床诊断没有显著的影响。

Objective The purpose of this study was to compare the enhancement degree of abdomen organs and vessels after different amount of contrast medium using saline flush in abdomen MDCT scanning, which aimed to not affect contrast en-hancement, decreased the amount of contrast medium, and reduced the side-effect. Methods This study group consisted of 75 patients who were referred for contrast enhanced abdominal MDCT for various reasons. Patients were allocated into three groups： injection of 100mlof contrast medium only （A group）, injection of 80ml pushed with 20ml of saline solution （B group）, and injection of 70ml pushed with 30ml of saline solution （C group） . Attenuation values were measured from the liver, spleen, pancreas, kidney, aorta, portal vein, and inferior vena cava in 33 second and 80 second of imaging after injection contrast medium. Results The portal venous phases of the spleen, pancreas, kidney, aorta, portal vein had statistically significant difference among groups A, B and C. Post hoc test showed statistically significant difference between A group and C group, But no statistically significant difference during the portal venous phases of the pancreas and the kidney between A group and B group. Conclusion Using a saline flush technique after the injection contrast medium in abdominal MDCT reduced waste of contrast medium and decrease in nephrotoxicity, at the same time, it would not lose important diagnostic information and saved patients cost for the contrast medium.