减少对比剂量在CTPA中的可行性探讨

Reduced Contrast Dose CTPA in the Feasibility Study

目的:通过比较图像质量,探讨减少对比剂用量在肺动脉CTA(CTPA)中临床应用的可行性。资料与方法:采用西门子公司64排128层螺旋CT机,将60例临床拟诊为肺动脉栓塞(PAE)患者随机分为A、B、C三组(n=20):A组,对比剂60mL+40mL生理盐水;B组,对比剂30mL+40mL生理盐水;C组,对比剂20mL+40mL生理盐水,其他的扫描参数相同,采用对比剂追踪自动触发扫描。将获取原始数据传到工作站,由1位影像科副主任医师和主管技师,在轴位测量肺动脉干、左、右肺动脉降支及左、右肺静脉的CT值,并对血管强化程度、重组血管分支显示进行评价。结果:A、B、C三组在肺动脉干、左、右肺动脉降支的平均CT值分别为:(513.20Hu、504.34Hu、509.54Hu)、(498.14Hu、497.43Hu、499.63Hu)、(486.31Hu、489.45Hu、491.49Hu),三组之间差异不具有统计学意义(P>0.05);三组的左、右肺静脉的平均CT值分别为:(235.41Hu、176.31Hu、119.91Hu)、(241.01Hu、169.52Hu、129.54Hu),之间的差异具有统计学意义(P<0.05),组与组之间的肺动静脉具有明显统计学(P<0.01);重组肺动脉血管清晰度及分支血管显示也无明显差异(P>0.05)。结论:小剂量对比剂(20mL人/次)在CTPA中是可行的,既降低了对比剂(CM)对患者潜在的危害,又节约检查费用。

Objective:by comparing the image quality,reduce the dosage of contrast agent in pulmonary CTA(CTPA) in clinical application.Materials and methods:using Siemens 64 rows of 128 layer spiral CT,60 cases of clinically suspected pulmonary embolism(PAE) were randomly divided into A,B,C 3 group(n = 20),group A:contrast agent 60 mL + 40 mL saline,group B:contrast agent 30 mL + 40 mL saline,group C:contrast agent 20 mL + 40 mL saline,the other scanning parameters were identical,the contrast agent tracking automatic triggering scanning.Will obtain the original data to the workstation,by 1imaging department deputy chief physician and chief technician,in the axial position measurement of pulmonary artery trunk,left,right pulmonary artery from the descending branch of right pulmonary vein and left,CT value,and the vascular enhancement degree,evaluation of recombinant vascular branches.Results:A,B,C 3 group in the pulmonary trunk,left,right pulmonary artery from the descending branch of the average CT values are:(513.20 Hu,504.34 Hu,509.54 Hu),(498.14 Hu,497.43 Hu,499.63 Hu),(486.31 Hu,489.45 Hu,491.49 Hu),the difference between the 3 groups was not statistically significant(P > 0.05),3 groups of left,right pulmonary vein average CT values are:(235.41 Hu,176.31 Hu,119.91 Hu),(241.01 Hu,169.52 Hu,129.54 Hu),difference has statistics significance(P < 0.05),between groups of pulmonary arteriovenous is statistically significant(P < 0.01);recombinant lung vascular definition and branch vessels showed no significant differences(P > 0.05).Conclusion:a small dose of contrast agent(20 mL/time) in CTPA is feasible,not only reduces the contrast agent(CM) on patients of potential hazards,and save the cost of examination.