64层螺旋CT冠状动脉CTA对比剂浓度选择优化

The Optimization of the Concentration of Contrast Media in Heart Coronary CTA by 64-MDCT

目的探讨不同浓度对比剂在64层螺旋CT冠状动脉CT血管造影(CTA)中的应用价值。资料与方法将51例行冠状动脉CTA筛查者随机分为3组,分别采用300mgI/ml、370mgI/ml、400mgI/ml浓度的对比剂,以相同注射流率(5ml/s)行增强扫描,对血管强化程度、重组血管清晰度进行评价。结果370mgI/ml、400mgI/ml组冠状动脉强化明显高于300mgI/ml组(P<0.05),370mgI/ml组与400mgI/ml组差异无统计学意义,重组血管的图像质量3组间无差异。结论64层螺旋CT冠状动脉CTA检查时,300mgI/ml、370mgI/ml、400mgI/ml3种浓度的对比剂在注射流率相同时均能满足诊断;在使用高浓度对比剂时,可适当降低注射流率。

Objective To prospectively investigate which concentration contrast media is more adequate for the coronary artery angiography by 64 multi-detector row computed tomography （64-MDCT）. Materials and Methods A total of 51 patients were divided into three groups and consecutively underwent 64-MDCT coronary angiography. 300 mgI/ml,370 mgI/ m1,400 mgI/ml concentration contrast medias were used, respectively, with fixed injection protocols ： 60-80 ml of contrast medial followed by 50 ml saline, at injection rate, of 5 ml/s. Bolus test was used to ensure time of start scanning. The attenuation value was measured at proximal coronary artery. The reconstruction image quality of right coronary artery（RCA） ,left anterior-descending artery（LAD） and small branches （SM） was assessed by applying a four-step grading scale. Kruskal- Wallis test, One-Way ANOVA test and Spearman correlation analysis were used for statistical analysis. Results The enhancement of coronary artery in groups 400 mgI/ml and groups 370 mgI/ml were higher than that of groups 300 mgI/ml （ P 〈 0.05 ） ;The difference between two former groups was insignificant （ P 〉 0.05 ）. The mean CT values of three groups at RCA were 454.6 ± 76.4,432.4 ± 74.6,362.8 ± 91.8, respectively, and those at LAD were 441.4 ± 70.4,438.4± 64.7, 373.1 ± 84.9, respectively. There were no significant differences in the reconstruction image quality of RCA, LAD and SM （P 〉 0.05 ）. Conclusion The 300 mgI/ml concentration contrast media is adequate for coronary artery angiography by 64-MDCT,at the injection rate of 5 ml/s. The reconstruction images enable diagnosing coronary artery disease.