多期双流速注射对比剂-盐水混合物在64层螺旋CT冠状动脉造影中的应用

Multiphase Contrast Saline Mixture Injection with Dual Flow in Coronary CT Angiography Using 64-slice Spiral CT

目的初步探索多期双流速注射对比剂-盐水混合物在64层螺旋CT冠状动脉造影中的应用价值。资料与方法24例患者进行64层螺旋CT冠状动脉造影成像。其中,12例(A组)在团注对比剂后应用生理盐水,12例(B组)在团注对比剂后应用对比剂-盐水混合物(比例为60∶40)。由2名有经验的放射科医师分别测量两组升主动脉根部、降主动脉、主肺动脉及右心室的CT值,评价冠状动脉的显示、右心室的均匀性及左心室室壁的显示。结果经Kappa检验,两名医师均有良好的组内、组间一致性(K>0.75)。经独立样本t检验,两组升主动脉根部和降主动脉的平均CT值差异无统计学意义(P>0.05);两组主肺动脉和右心室的平均CT值差异有统计学意义(P<0.05)。经配对秩和检验,在冠状动脉的显示和右心室的均匀性方面,两组差异无统计学意义(P>0.05);在左心室室壁的显示方面,两组差异有统计学意义(P<0.05)。结论在CT冠状动脉造影检查中,团注对比剂后应用对比剂-盐水混合物可以更好地显示右心室心腔和左心室室壁,而不影响冠状动脉的成像效果。

Objective To explore the value of multiphase contrast-saline mixture with dual-flow coronary CTA using 64 slice spiral CT initially. Materials and Methods 24 patients were performed coronary CTA with 64 slice spiral CT （CE Lightspeed VCT）. In 12 patients （group A）, contrast bolus was followed by a saline flush, and in the other 12 patients （group B）, contrast bolus was followed by a contrast-saline mixture at 60.40 ratio. Two experienced radiologists measured the CT values of ascending aorta, descending aorta, pulmonary artery and the right ventricle, rated the uniiformity of the right ventricle, the visualization of the coronary artery and the wall of left ventricle independently. Results By Kappa test, two radiologists had good intra-and inter-group consistency （ K 〉 0.05）. By t test, the mean CT value of ascending aorta and descending aorta of the two groups had no statistical difference （P 〉 0.05） ; while the mean CT value of pulmonary artery and the right ventricle had statistical differences （ P 〈 0.05）. By two-related rank sum test, according to the visualization of the coronary artery and the uniformity of the right ventricle, there were no statistical differences （ P 〉 0.05） ; while according to the visualization of the wall of the left ventricle, group B was better than that of group A （ P 〈 0.05）. Conclusion In eorouary CTA, a conlrasl-saline mixture after contrast bolus can provide clear visualization of the right ventricle and the wall of left ventricle without impairing coronary artery image.