螺旋CT经下肢静脉注射造影剂增强检查参数的研究

Spiral CT Study on Intravenous Contrast-enhanced Inspection Parameters of the Lower Extremities

目的:探讨患者螺旋CT经下肢静脉注射造影剂增强检查的最佳扫描参数,以便经下肢静脉注射造影剂达到经上肢静脉注射造影剂螺旋CT增强检查诊断图像效果。资料与方法:收集400例患者CT增强检查资料。其中实验组200例,由于长期上肢静脉注射造成静脉血管损伤严重的患者,在进行增强CT检查中,采取经下肢静脉(脚、踝部静脉血管为主)注射造影剂螺旋CT增强检查,注射速率以2.5～3.3mL/s,非离子型造影剂70～100mL,动脉期及静脉期根据组织器官均较上肢静脉注射造影剂延长延迟时间8～15s,螺旋CT扫描范围包括检查器官上下范围,病变区加扫薄层;对照组200例,经上肢肘静脉注射造影剂增强CT检查患者,依组织器官不同注射速率、非离子型造影剂量及螺旋CT扫描范围方法与实验组相同,动脉期及静脉期根据组织器官注射造影剂设定延迟时间。分析测量两组CT图像正常组织、血管及病变组织CT值和扫描曲线,进行统计学分析。结果:200例实验组经下肢静脉(脚、踝部静脉血管为主)注射造影剂螺旋CT增强检查病例与对照组200例经上肢肘静脉注射造影剂增强CT检查患者,增强检查图像质量经统计学分析相近。上肢动脉期CT值和下肢动脉期CT值配对比较,统计学分析t值为4.371,P=0.000,这两组存在显著性差异,具有统计学意义,即上肢动脉期CT值和下肢动脉期CT值存在差异。上肢静脉期CT值和下肢静脉期CT值配对比较,t值为-1.664,P=0.103>0.05,这两者的差异没有统计学意义,没有显著性差异,即上肢静脉期CT值和下肢静脉期CT值差异没有统计学意义,二者不存在差异性。结论:长期上肢静脉注射造成静脉血管损伤严重患者,经下肢静脉注射造影的增强扫描采取适当的增加延迟时间扫描完全可以达到上肢静脉注射造影剂螺旋CT增强扫描图像质量。

Objective：To study chronic lower limb intravenous contrast-enhanced spiral CT examination of optimal scanning parameters so that the intravenous contrast agent reached by upper limbs lower limbs of intravenous contrast-enhanced spiral CT diagnosis of image effects. Materials and methods：a collection of 400 patients with chronic diseases CT enhanced check information. Which 200 cases experimental group due to long-term upper limb intravenous caused vein vascular injury serious chronic disease people, in for enhanced CT check work in the, take by lower limb vein （feet, and ankle Department vein vascular mainly） injection contrast agent spiral CT enhanced check, injection rate to 2.5～3.3 mL/s, non-ion type contrast agent 70～100 mL, artery period and the vein period under organization organ are more upper limb intravenous contrast agent extended delay time 8～15 seconds, Spiral CT scans include checks organ range, lesions and sweep the thin layer; control group of 200 patients with intravenous contrast-enhanced CT examination of the elbow chronic diseases of upper limb, depending on the tissues and organs of different injection rate, non-ionic contrast dose and spiral CT scanning method and experimental groups are the same, arterial and venous injection contrast set the delay time for the period according to the tissues and organs. Two sets of normal tissue CT image analysis of measurement and pathological tissue CT value and scan curves, and for statistical analysis. The result：Experimental group of 200 cases of lower limb vein （foot, ankle, vein） injection of contrast-enhanced spiral CT examination of cases linked to the control group of 200 cases of intravenous contrast-enhanced CT examination of the elbow in the upper limbs chronic enhanced check image quality similar to the statistical analysis. Upper and lower limbs arterial CT value arterial CT value is matching, the statistics analysis t value is 4.371, P = 0.000, think that the two groups there exist significant differences, have a statistics meaning, that is, upper and lower limbs arterial CT value arterial CT value in different ways. Upper limbs vein phase CT value and venous phase CT value matching comparison, t value is 1.664, P = 0.103 0.05, think it＇s the difference between them was not statistically significant, no significant difference, that is, upper limbs vein phase CT value and venous phase CT value difference was not statistically significant, believe that the difference does not exist. Conclusion：Long-term serious chronic diseases caused by intravenous injection of vein injury of upper limbs after intravenous contrast-enhanced scan of lower extremity take appropriate scans can increase latency time achieved quality of intravenous contrast-enhanced spiral CT scan of upper extremity.