低浓度碘对比剂联合低剂量MSCT扫描技术在肝脏血管成像中的临床应用研究

The Clinical Research of Low Concentration of Lodine Contrast Agent Combined with Low Dose MSCT Scanning Technique in Hepatic Angiography

目的探讨使用270 mgI/ml低浓度碘对比剂联合低剂量MSCT扫描技术在肝脏血管成像中的价值。方法选择60例临床疑诊肝胆病变的患者行64排螺旋CT三期增强扫描。将患者随机分为两组,对照组30例使用欧乃派克350对比剂(碘浓度350 mgI/ml)、管电压120 kV;双低组30例使用威视派克270对比剂(碘浓度270mgI/ml)、管电压100 kV。在CT后处理工作站分析两组病例腹主动脉、腹腔干、肝动脉、门静脉主干及肝实质的增强效果及血管显示情况,并统计各组X线辐射剂量及对比剂不良反应发生情况。结果双低组患者的腹主动脉、腹腔干、肝总动脉动脉期CT值及增强三期肝实质CT值与对照组的差异无统计学意义(P>0.05),双低组患者的门静脉主干CT值高于对照组、差异具有统计学意义(P<0.05)。双低组与对照组在肝动脉、门静脉目测图像对比效果评价方面的差异无统计学意义(P>0.05)。在辐射剂量方面双低组与对照组差异有统计学意义(P<0.05),双低组中发热等不适感反应显著少于对照组。结论低浓度碘对比剂联合低剂量MSCT扫描技术可以获得满意的肝脏血管成像图像,同时降低了辐射剂量和对比剂不良反应。

Objective To discuss the value of MSCT scanning technique of low concentration contrast media combined with low dose in hepatic vascular imaging. Methods 60 patients with clinically suspected hepatic lesions underwent threephase dynamic scan with contrast media and were randomly dividedly into two groups： 30 patients in control group re ceived Iohexol 350mgl/ml with tube voltage of 120 kV, and the remaining 30 patients in double low group received Vi sipaque 270 mgI/ml with tube voltage of 100 kV. The enhancement of the vessel will be assessed by CT values of abdomi nal aorta, celiac trunk , common hepatic artery, portal vein and the three phases enhanced liver parenchyma on image post processing workstation. The Xray radiation as well as the incidence of adverse reactions were calculated. Results The CT values of abdominal aorta, celiac artery, hepatic artery and liver parenchyma of three phases between the control group and the double low group had no statistical significance （ P 〉 O. 05 ）. The CT values of portal vein in double low group was high er than that in the control group and the difference was statistically significant （ P 〈 O, 05 ）. The differences between the double low group and the control group in the visual evaluation of hepatic artery and portal vein were no statistically signifi cant （P 〉 0.05）. In the radiation dose of double low group and the control group, the difference was statistically signifi cant （P 〈 0.05 ）. The incidence of discomfort such as fever in the double low group was significantly less than that in the control group. Conclusion Low concentration of iodine contrast agent combined with low dose MSCT scanning technique can obtain satisfactory hepatic angiography image, while reducing the radiation dose and adverse reaction of contrast agent.