磁显葡胺用作DSA造影剂的实验性研究

Experimental Study of Gd-DTPA Used as An Alternative Contrast Media for DSA

目的：寻求一种能安全有效地用于ＤＳＡ的含碘造影剂的代用品。材料和方法：（１）体外试验：对不同浓度的磁显葡胺（Ｇｄ－ＤＴＰＡ）及Ｏｍｎｉｐａｑｕｅ分别进行不同条件下的ＣＴ扫描，并分别测定各自的ＣＴ值，得出浓度－ＣＴ值曲线和回归方程，然后根据回归方程计算两种造影剂间的等效浓度和衰减比值。（２）体内试验：用０．５ｍｏｌ／Ｌ，０．２５ｍｏｌ／Ｌ，０．１７ｍｏｌ／Ｌ的Ｇｄ－ＤＴＰＡ及３００ｍｇＩ／ｍｌ的Ｏｍｎｉｐａｑｕｅ作为造影剂对１６只随机分为四组的新西兰大白兔分别进行腹主动脉插管、主动脉、锁骨下动脉、腹主动脉、肠系膜上动脉造影，造影结果分四级进行记录。结果：体外实验中，０．５ｍｏｌ／Ｌ的Ｇｄ－ＤＴＰＡ的ＣＴ值相当于８０～１００ｍｇＩ／ｍｌ的Ｏｍｎｉｐａｑｕｅ，其产生的Ｘ线衰减为相同浓度Ｏｍｎｉｐａｑｕｅ的２．５８～３．０６倍，随扫描电压条件提高，Ｇｄ－ＤＴＰＡ衰减值的下降要小于Ｏｍｎｉｐａｑｕｅ。在体内试验中，对于中、小动脉，两种造影剂效果均较满意， ０．５ｍｏｌ／Ｌ的Ｇｄ－ＤＴＰＡ与３００ｍｇｌ／ｍｌ的Ｏｍｎｉｐａｑｕｅ间无明显统计学差别（ｐ＞ ０．０５），对于较粗大动脉，三种浓度Ｇｄ－ＤＴＰＡ的造影效果均较差，?

To seek a safety and effective alternative noniodinated contrast media for DSA. Materials and Methods: In vitro,serial dilution of Gd-DTPA and Omnipaque were placed in a CT scanner (Shimazu 5000), ROI attenuation measurements were made from 5mm thick axial section (80/ 120 /130kV, 160mA, 2s). And the concentration-CT value curves and regression equations were obtained. The equivalent concentration and attenuation ratio of these two contrast media were calculated by the equations. In vivo, 16 rabbits, which were 2.5 - 3.5kg in weight, were divided into four groups ramdonly. Then aorta, subclavian artery, abdominal aorta and supramenstric artery angiography were undergone with 0.5mol/L, 0.25mol/L, 0.17mol/LGd-DTPA and 300mgI/ml Omnipaque separately. The angiography results were recorded in four grades. Results: The attenuation of 0.5mol/L Gd-DTPA was equal to that of 80 - 100mgI/ml Omnipaque, and was 2.58 - 3.06 times as the same concentration of 300mgI/ml Omnipaque. With the increase of the kV, the fall of attenuation of Gd-DTPA was less than that of Omnipaque. The middle and small arteries of the rabbits were good visualized when undergone DSA with 0.5moI/L Gd-DTPA and 300mgllml Omnipaque, no statistic difference between those with these two contrast media(p>0.05). The big arteries were poor visualized with Gd-DTPA, statistic difference between those with Gd-DTPAand with Omnipaque(p<0.05). Conclusion: To small and middle arteries using Gd-DTPA as an alternative contrast media for DSA is acceptable, but the clinical use still needs futher study.