不同穿刺部位对颈部MSCT血管造影效果的影响

Influence of different puncture sites on the effects of cervical MSCTA

目的探讨不同穿刺部位对颈部多层螺旋CT（MSCT）血管造影效果的影响。方法将该院2013年1-6月收治的150例行颈部MSCT血管成像检查的患者随机分为左肘静脉组和右肘静脉组,各75例,分别经左肘静脉注射和右肘静脉注射碘对比剂,并对两组患者的血管造影效果进行比较分析。结果右肘静脉组患者效果满意度为98.7%（74/75）,左肘静脉组患者效果满意度为82.7%（62/75）,两组比较,差异有统计学意义（P〈0.05）;右肘静脉注射组对比剂反流发生率[16.0%（12/75）]明显低于左肘静脉[33.3%（25/75）],而右肘静脉组颈总动脉CT值、颈内静脉CT值[（356.2±52.6）、（245.8±48.7）HU]明显高于左肘静脉组[（305.6±37.5）、（198.6±45.3）HU],差异均有统计学意义（P〈0.05）。结论颈部MSCT血管成像时选择右肘静脉注射碘对比剂可有效地提高颈部动脉内对比剂的浓度,减少颈静脉反流和X射线束硬化伪影,提高颈部血管造影效果和图像质量。

Objective To detect the influence of different puncture sites on effect of cervical multislice computed tomog- raphy angiography （MSCTA）. Methods A total of 150 patients underwent cervical MSCTA ,who were enrolled in the hospital from January to June of 2013 were randomly divided into left elbow vein group and right elbow vein group ,75 cases in each group ,which were accepted the left elbow intravenous and the right elbow intravenous respectively. The effects of MSCTA between the two groups were compared. Results The satisfactory degree of patients was 98.7% （74/75） in right vein group and 82.7% （62/75）, the difference between the two groups had statistical significance （P〈0.05）. Carotid artery CT value and jugular vein CT value in the right elbow vein group were obviously higher than those in the left elbow vein group, but the regurgitation of contrast agent in the right elbow vein was prominently lower than that in the left elbow vein group, with statistically significant difference （P〈0.05）. Conclusion The cervical MSCTA with right elbow intravenous of contrast agent can improve the cervical artery contrast medium concentration, reduce the jugular vein regurgitation and X-ray beam hardening artifact, improve the effect and image quality of cervical angiography effectively.