不同对比剂用于螺旋CT胃部三维成像的对照研究

The comparative study of various oral contrast media in 3D display of gastric lesions in spiral CT

目的 合理选择螺旋CT胃部三维成像口服对比剂。方法 41例胃部疾病患者进行了49次胃部CT专一检查 ,将使用的口服对比剂随机分为 3组 :空气对比剂组 17例 ;脂肪乳剂对比剂组7例 ;阳性对比剂组 2 5例。经螺旋CT容积扫描后分别使用CT仿真内窥镜 (CTVE)、表面遮盖法(SSD)、透明法 (RaySum)及多层面重建 (MPR)技术进行胃部三维成像 ,所获得的图像与胃镜和 (或 )胃肠道钡餐检查 (GI)进行对照 ,比较不同对比剂对三维重建图像的影响。结果 脂肪乳剂组、空气对比剂组及阳性对比剂组的病灶检出率分别为 42 9% (3/ 7)、80 0 % (2 0 / 2 5 )及 10 0 0 % (30 / 30 ) ,使用不同对比剂与病灶检出率有关 ,前两者与后者之间的差异均有显著性意义 (χ2 分别为 19 2 2和 6 6 0 ,P值均 <0 0 5 ) ;不同的对比剂对病灶细节的显示也有很大的影响 ,以阳性对比剂最好 (χ2 =17 0 4,P <0 0 1)。结论 口服对比剂的选择在胃部螺旋CT三维重建技术中有重要作用 ,以阳性对比剂为优。

Objective To optimize the oral contrast media in three-dimensional display of gastric lesions. Methods 41 cases were randomly divided into 3 groups according to different oral contrast media administered: No. 1 air contrast group (n=17), No. 2 fat emulsion group (n=7) and No. 3 positive contrast group (n=25). The 3D CT images were reconstructed using MPR, SSD, RaySum display and virtual endoscopic techniques, and compared with gastric endoscopy and/or conventional barium study.Results The detectability of gastric lesions using fat emulsion and air contrast was 42.8%(3/7) and 80.0%(20/25), respectively, both were significantly lower than that using positive contrast (100%, 30/30) (χ2=19.22,P<0.01;χ2=6.60, P<0.05). The capability of showing the details of stomach lesions was significantly affected by the oral contrast media administered(χ2=17.04,P<0.01). Conclusion It is very important to choose the appropriate oral contrast media for 3D display of gastric lesions in spiral CT, the positive contrast agent is the optimal choice.