胃肠道癌多层面CT检查最佳扫描时相的探讨

Optimal delay time of contrasted abdominal multi-detector helical CT for patients with gastrointestinal carcinoma

目的探讨胃肠道癌多层面CT(MSCT)检查的最佳扫描时相。方法 A组:胃癌15例、结肠癌20例以3ml/s的速度静脉注射300mgI/ml的对比剂30ml作病灶同层动态增强扫描,得出时间-密度曲线。测峰时作统计处理。B组:胃肠道癌164例低张充气三期增强扫描,以3ml/s的速度静注300mgI/ml的对比剂100ml,注射后22s(动脉早期)、37-40s(动脉晚期)、60s(门静脉期)扫描。统计处理病灶强化情况。结果 A组:胃癌组、结肠癌组的病灶强化峰时均数95%可信区间分别为延迟41.37～49.25s、46.06～53.64s。B组:胃癌组,56.94%的病例在动脉晚期病灶显示最清楚。结肠癌组,53.26%病例在动脉晚期病灶显示最清楚。这两组扫描的动脉晚期与门静脉期病灶强化差异无显著性意义。结论推荐MSCT在诊断胃肠道癌检查的扫描时相为开始注射对比剂(以3ml/s的速度静注)后22s(动脉早期)、37-40s(动脉晚期)、60s(门静脉期)。一次检查获腹部多方信息。

Objective To investigate the optimal multi-phase enhanced delay time of multidetector helical CT（MDCT） in patients with gastrointestinal carcinoma. Methods Patients of two groups were studied. In group A, patients （15 with gastric cancer, 20 with colon cancer） underwent enhanced dynamic CT scanning of the cancer lesions by means of i.v. injection of 30 ml cont rast （300mgI/ml） at 3ml/ s rate,the time-density curves of the enhancement in cancer lesions were obtained. In group B, one hundred and sixty-four patients with gastrointestinal carcinoma underwent multi-phase enhanced abdominal CT examination. Contrasted MDCT scans were performed at 22s（ early artery phase）,37-40 s（late artery phase）and 60 s（portal vein phase）after intravenous administration of 100 ml cont rast （300mgI/ml） at 3ml/ s rate. The imaging quality and CT value of cancer lesions were evaluated. Results In group A, the average delay time of the peak enhancement of gastric cancer and colon cancer were 41.37-49.25s and 46.06-53.64 s respectively with 95% confidence interval. In group B, cancer lesions were optimally display at late artery phase in 56.94% patients with gastric cancer and in 53.32% patients with colon cancer. The enhanced degree of gastrointestinal carcinoma did not show statistically significant difference between late artery phase and portal vein phase. Conclusions The optimal multi-phase enhancement scan of MSCT for patients with gastrointestinal carcinoma was performed at 22s（ early artery phase）,37-40 s（late artery phase）and 60 s（portal vein phase）after intravenous administration of 100 ml contrast （300mgI/ml） at 3ml/ s rate, which might provide more information.