低剂量对比剂联合生理盐水在MSCT双期脑血管成像中的应用

Application of contrast material with normal saline on MSCT double phase cerebral angiography

目的探讨低剂量对比剂加生理盐水冲洗对MSCT双期脑血管成像图像质量的影响。方法60例受试者平均分为两组:A组:低剂量对比剂+生理盐水;B组:76ml对比剂。以Test-Bolus确定脑动、静脉期延迟扫描时间,对两组受试者行MSCT双期扫描,比较CT动脉成像(CTA)、CT静脉成像(CTV)图像质量差异。结果Test-Bolus测试血管循环时间组间差异无统计学意义,CTA脑动脉分支显示及静脉干扰评分、动脉最大强化均值、动静脉最大强化差值的组间差异均无统计学意义。CTV脑静脉窦最大强化均值的差异不显著,B组均匀性优于A组(P<0.001),深浅静脉最大强化均值大于A组(P=0.02)。静脉显示评分差异无统计学意义。A组静脉窦、深浅静脉与动脉最大强化差值均大于B组(P<0.001,P<0.001),CTV期动脉强化干扰程度低于B组(P<0.001)。结论低剂量对比剂加生理盐水冲洗不影响脑CT血管图像质量,同时能显著降低CT静脉成像期的动脉干扰,不影响脑静脉清晰显示。

Objective To evaluate the application of contrast material with normal saline flush on MSCT double phase cerebral angiography. Methods Sixty patients were enrolled in the study and randomly divided averagely into Group A （ low dose contrast material with normal saline flush） and Group B （76 ml contrast material）. Patients in each group underwent Test Bolus and MSCT double phase cerebral angiograpby. Image quality of CTA and CTV was compared between two groups. Results There was no significant difference in arterial venous circulation time by Test Bolus between groups. No statistical difference was observed in the scores of the arterial branches display, vein interruption grading, mean value of maximal artery enhancement, mean value of maximal sinus venosus enhancement nor of artery and vein between two groups. Homogeneity was better showed in Group B than in Group A, as so as mean value of maximal deep and superficial vein enhancement. Differences of sinus venosus, deep/superficial vein and artery in Group A were higher than those in Group B. Interruption grading in CTV in Group A was lesser than that of Group B. Conclusion Image quality of CTA and of the veins displaying in CTV was not affected with low dose contrast material with saline flush. Meanwhile, contrast material with saline flush decreased the level of interference from the enhanced arteries in CTV.