头颈部CT增强中造影剂静脉返流征象及预防

Venous Reflux Signs of Contrast Agent and the Prevention in Head and Neck CT Enhancement

目的探讨头颈部CT增强中造影剂返流征象和预防措施。方法选择的42例均采取平静吸气,从肘静脉高压团注造影剂扫描,左肘34例,右肘8例。结果静脉返流表现为大量对比剂返流至颈部深、浅静脉及颅内静脉窦,右侧返流占多数,包括颈前静脉及颈静脉弓返流12例、颈外静脉19例、甲状腺上静脉7例、耳后静脉2例,颈内静脉24例,项部静脉6例、椎静脉12例、椎旁静脉丛16例,髁前静脉6例,返流造影剂表现为静脉显影早于伴行动脉,密度极高,有线束硬化伪影、分布不均且有典型分层改变。结论在头颈部CT增强过程中,由于各种客观因素影响,虽不可避免产生一定程度造影剂返流,但是我们针对性采取一些措施后仍然能将其控制在可接受范围,获得良好的增强图像,提高检查质量。

Objective To explore venous reflux signs of contrast agent and the prevention in Head and neck CT enhancement. Methods 42 cases took resting aspiration and hypertension bolus of contrast agent by ulnar vein （34 cases in left elbow, 8 cases in right elbow）. Results Venous reflux performed as mass of contrast agent reflux into deep cervical vein. superficial cervical vein and intracranial venous sinus, which majoy happcnned in the right side, including 12 cases of anterior jugular vein and jugular venous arch reflux, 19 cases of exlernal jugular vein, 7 cases of superior thyriod vein, 2 cases of posterior auricular vein, 24 cases of internal jugular vein, 6 cases of napex vein, 12 cases of vertebral vein, 16 cases of paravertebral venous plexus, and 6 cases of anterior condylar vein. Contrast agent reflux showed that veins developed earlier than the accompanying arteries, and veins showed very high density, wire harness sclerosis artifact, uneven distribution and a typical htyered change. Conclusion In the head and neck CT enhancement process, it inebitably produce a certain degree of contrast agents reflux because of some subjective factors, but it can be controled in an acceptable extemt by some specific easures, and acquire good enhancement images and improve inspection quality.