CT冠状动脉成像中两种碘浓度对比剂成像效果比较

Effects of contrast media with two different iodine concentrations on CT coronary angiography

目的探讨不同碘浓度对比剂对16层螺旋CT冠状动脉成像的影响。方法连续收集107例行CT冠状动脉成像检查的患者,分别予Ioversol 320(Ioversol 320组,n=55)和Iohexol 350(Iohexol 350组,n=52),以4.0 mL/s团注速率进行成像,以回顾性心电门控的方法进行冠状动脉重建。分别测定各个感兴趣区增强后的CT值。按美国心脏学会的15段分类法对冠状动脉进行血管分段,并根据图像质量评分。分析两组间各项指标的差异。结果在主动脉根部和降主动脉所测CT值和4支冠状动脉起始段所测平均CT值,Iohexol 350组均显著高于Ioversol 320组(P<0.05)。两组间图像质量平均评分及可分析和诊断的冠脉节段比例比较,Iohexol 350组均显著优于Ioversol 320组(P<0.01)。结论在16层螺旋CT冠状动脉成像中,使用较高碘浓度的对比剂能够获得更佳的冠状动脉显影,从而提高图像质量。

Objective To investigate the effects of contrast media with different iodine concentrations on attenuation on 16- slice CT coronary angiography. Methods A total of 107 patients scheduled for CT coronary angiography were enrolled. They were administered Ioversol 320 （ Ioversol 320 group, n = 55） or Iohexol 350 （ Iohexol 350 group, n = 52） at a flow rate of 4.0 mL/s. The attenuation achieved after administration of contrast media was determined at regions of interest. Fifteen coronary segments were analyzed in each patient according to American Heart Association Classification. Differences of each parameter were evaluated between groups. Results The mean enhancement on the ascending aorta, descending aorta and average attenuation at the origin of coronary arteries in Iohexol 350 group were significantly greater than those in Ioversol 320 group （P 〈0.05）. Furthermore, the average image quality score and diagnostic segment accessibility in Iohexol 350 group were significantly higher than those in Ioversol 320 group （P 〈 0.01 ）. Conclusion Use of higher-concentration （350 mgI/mL） contrast madium provides better contrast enhancement and improved image quality for coronary angiography on 16-slice CT.