400mgI/ml和370mgI/ml造影剂在脊髓血管CTA中的应用对比

Comparison of effectiveness of 400 mgI/ml and 370 mgI/ml nonionic contrast medium on spinal CTA

目的:比较400 mgI/ml与370 mgI/ml非离子碘造影剂在脊髓血管CTA中能否提高脊髓前动脉、大根髓动脉的图像质量。方法:103例患者分为370 mgI/ml组(51例)和400 mgI/ml组(52例),行多排CT脊髓血管CTA扫描,图像经颅脑CT算法及小视野二次重建,对比(1)降主动脉起始段CT值;(2)脊髓前动脉(ASA)和大根髓动脉(AA)显示率;(3)AA走行各段对比噪声比(CNR);(4)ASA和AA图像质量评分。结果:370 mgI/ml组和400 mgI/ml组降主动脉起始段血管内密度分别为(305.5±23.7)HU和(367.4±19.8)HU,组间有统计学差异(t=2.23,P<0.05);370 mgI/ml组和400 mgI/ml组的ASA和AA的显示率均为100%;370 mgI/ml组和400 mgI/ml组AA各段的CNR分别为:(1)AA起源血管段(肋间动脉或腰动脉):24.11±4.43和27.88±5.12,组间有统计学差异(t=3.998,P<0.05);(2)椎间孔段:7.23±4.28和7.87±4.72,组间无统计学差异(t=0.316,P>0.05);(3)椎管内段:6.08±1.17和6.53±1.52,组间无统计学差异(t=0.894,P>0.05);(4)汇入ASA动脉后:9.72±1.91和9.49±2.01,组间无统计学差异(t=0.564,P>0.05)。ASA和AA的图像质量评分显示370 mgI/ml组和400 mgI/ml组组间没有统计学差异(χ2=0.317,P>0.05;χ2=0.569,P>0.05)。结论:多排CT脊髓CTA中,使用400 mgI/ml非离子碘造影剂与370 mgI/ml非离子碘造影剂相比可以增加血管强化,但并不能显著提高ASA和AA图像质量。

Objective： To test the hypothesis that the 400 mgI/ml nonionic contrast medium can promote CTA image quality of the anterior spinal artery（ASA） and artery of Adamkiewicz （ AA ）, compared with 370 mgI/ml nonionic contrast medium. Methods ： 103 patients who underwent spinal CTA scan were divided into two groups ： 370 mgI/ml group （ n = 51 ） and 400 mgI/ml group （ n = 52 ）. Raw image data was reconstructed by adapted brain algorithms and small DFOV. It was studied ： （ 1 ） CT value in originated part of the descendent aorta; （ 2 ） the visualization of ASA and AA in CTA; （3） contrast - to - noise ratios （CNR） at four deferent levels along the course of AA; （4） the image quality scores of ASA and AA. Results： CT value in originated part of the descendent aorta was （305.5 ±23.7 ） HU in 370 mgI/ml group and （367.4± 19.8 ） HU in 400 mgI/ml group, there was a statistic difference between them （ t = 2.23, P 〈 0.05 ）. The ASA and AA can be 100% visualized in all patients of both groups. The CNR of the feeding artery of AA （ intercostal artery or lumber artery） was 24.11 ± 4.43 and 27.88 ±5.12 in 370 mgI/ml group and 400 mgI/ml group, respectively. There was a statistic difference between them （ t = 3. 998, P 〈 0.05 ）. The CNR at the level of AA in vertebrae foramen, vertebrae canal and the cranial part of the ASA were 7.23 ± 4.28,6.08 ± 1.17 and 9.72 ± 1.91 in 370 mgI/ml group,as well as 7.87± 4.72,6.53 ± 1.52 and 9.49 ±2.01 in 400 mgI/ml group. However, all of CNR at the levels of the AA in vertebrae foramen （ t = 0. 316） , in vertebrae canal （t =0. 894） and the cranial part of the ASA（ t =0. 564） did not show significant difference between the two groups （P 〉0.05 ）. Furthermore, the image quality scores of ASA and AA indicated there were also no differences between them（Χ^2 = 0.317, P 〉 0.05 ;Χ^2 = 0. 569, P 〉0.05）. Conclusion： Compared with 370 mgI/ml nonionic contrast medium,400 mgI/ml contrast medium can provide higher attenuation of blood vessels due to its higher iodine concentrations, but it can not promote the image quality of ASA and AA in multi - detector CT （MDCT） spinal CTA examination.