16层螺旋CT动静脉双期脑血管成像的可行性研究

Feasibility study of 16 row multi-slice CT Arterial and Venous Phase cerebral angiography

目的:探讨16层螺旋CT动静脉双期脑血管成像的可行性。材料与方法:30例MSCTA病例,行Test-Bolus测试确定脑动、静脉期延时扫描时间,按低剂量优维显(370mgI/ml)+生理盐水冲洗行MSCT双期扫描,评价CTA、CTV图像脑动、静脉血管显示及相互干扰程度。评分标准:按静脉或动脉基本无、淡薄、部分、大部分显影及等同强化分别评为5、4、3、2、1分。结果:Test-Bolus测试血管循环时间为8.15±2.29秒。全颅扫描时间为5.17±0.20秒。动脉期延时时间为15.37±1.92秒,静脉期延时时间为27.54±3.07秒,对比剂平均剂量为45.07±2.91ml,生理盐水为39.93±2.96ml。CTA期29例(96.7%)脑动脉1-5段分支显示清晰,脑动静脉最大强化差值为353.86±73.15HU,静脉干扰评分为:5分9例(30%),4分13例(43.3%),3分8例(26.7%)。CTV期27例(90.0%)脑静脉系统显影清晰,静动脉最大强化差值为299.51±90.09HU;动脉干扰评分为:5分4例(13.3%),4分18例(60%),3分6例(20%),2分2例(6.7%),双期均未见动静脉同等强化病例。结论:16层螺旋CT采用低剂量对比剂加生理盐水冲洗,结合小剂量测试,可得到大致类似DSA动、静脉期图像的CTA及CTV图像。

Purpose： To evaluate the feasibility of 16 row multi - slice CT arterial and venous phase cerebral angiography with once contrast material bolus. Materials and Methods： The delaying scan time of arterial and venous Phase were determined by the Test - Bolus. Thirty patients underwent MSCT double phase cerebral angiography with low dose contrast material bolus followed by saline solution flush. According the difference level enhancement of veins or arteries in CTA and CTV, the interference scores were ranked from 5 to 1. Results： The arterial -venous circulation time was 8. 15 ±2. 29S by Test - Bolus. The scan time of the entire skull and the delaying scan time of arterial and venous - phase were 5.17 ± 0. 20S, 15.37± 1.92s, 27.54±3.07S , respectively. The mean dose of constrast medium and of saline were 45.07±2.91ml and 39. 93 ±2.96ml. The arterial braches were displayed clearly in 29 cases （96.7 % ）and the difference CT value between arteries and veins were 353.86 ±73.15HU in CTA. The viens interference scores as follow： 9 （30%）, 13 （43.3%）and 8 （26.7%）cases were 5, 4, 3, respectively. The venous system were showed distinctly in 27 cases（90. 0% ） and the difference CT value between veins and arteries were 299.51 ± 90.09HU in CTV. The arteries interference scores as follow： 4 （ 13.3% ）, 18（60% ）, 6（20% ） and 2（6. 7% ） cases were 5, 4, 3, 2 , respectively. No equal enhancement of arteries and veins were observed in the CTA and CTV. Conclusion： With low dose contrast material bolus followed by saline flush and Test Bolus, 16 row multi -slice CT double phase cerebral angiography may distinguish arterial and venous phase similar to DSA.