两种碘浓度对比剂对肾脏CT增强扫描的对比研究

Comparison of Two Iodine Concentration of Contrast Media on Contrast Enhancement in Multislice CT of Kidney

目的:对比300 mgI.ml-1对比剂与400 mgI.ml-1对比剂对肾脏多层面CT(multislice CT,MSCT)多期增强扫描的强化作用及不良反应。材料与方法:68例腹部CT受检者随机分成两组各34例,分别给予肾脏平扫和典比乐300(300 mgI.ml-1)与碘迈伦400(400 mgI.ml-1)的多期增强MSCT扫描(在对比剂开始注射后18s、30 s、80 s、3 min^5 min),测量各期增强扫描腹主动脉、双肾动脉、双肾静脉、双肾皮质、双肾髓质、双肾盂的CT强化值。观察对比剂的不良反应。结果:使用400 mgI.ml-1对比剂在18s与30s采集,所检测的血管与肾各结构强化均值有意义高于300 mgI.ml-1对比剂(p<0.01),80 s采集,肾动脉、肾静脉、肾髓质强化均值有意义高于300 mgI.ml-1对比剂(p<0.01),3 min^5 min采集,肾静脉与肾盂强化均值有意义高于300 mgI.ml-1对比剂(p<0.01)。结论:高碘浓度对比剂对肾脏各解剖结构的显示优于标准碘浓度对比剂,并可降低对比剂用量,而不良反应并无增加。

Objective： To compare side effect and contrast enhancement with contrast media containing 300 and 400 mg iodine per milliliter in kidney multislices CT. Materials and methods： 68 patients were randomly assigned to two groups, each group contained 34 patients. Group A received contrast media containing 300mg iodine per milliliter （1.5 ml·kg weight^-1）, whereas group B received same agent containing 400 mg iodine per milliliter （1 ml-kg weight^-1） at a flow rate of 3 ml·s^-1. Imaging was performed at 18 s,30 s,80 s and 3 min to 5 min after starting injection of contrast media. Contrast enhancement （HU） of aortal, renal artery, renal venous, renal cortical and medulla, and renal pelvis were measured. Side effect of contrast was observed. Results： At 18 s and 30 s, high iodine concentration con- trast led to a significantly greater enhancement in blood vessels and renal anatomy than standard iodine concentration contrast（p〈0.01 ）. At 80 s, high iodine concentration contrast led to a significantly greater enhancement in renal artery, renal venous, renal medulla than standard iodine concentration contrast （p〈0.01）.3 to 5 min enhancement was significantly greater in renal venous and renal pelvis（p〈0. 01 ）. Conclusion： High iodine concentration contrast media improves contrast enhancement of renal and lead to lower overall volumes of administered contrast without increasing side effects.