低剂量对比剂联合生理盐水在宝石CT肺动脉血管成像中的应用

The application of the reduced dosage of the contrast medium with saline flushing in pulmonary angiography with gemstone CT

目的：探讨低剂量对比剂联合生理盐水在标准体重患者宝石CT 肺动脉血管成像中的可行性。方法：40例标准体重（体重指数18．5～24．0kg/m2）患者行CT肺动脉血管成像（CTPA），采用随机数字表达法根据对比剂使用剂量将患者分成两组：低剂量组，15 mL对比剂＋50 mL混合液（10％对比剂＋90％生理盐水）；对照组，50 mL对比剂＋30 mL生理盐水。由两名有经验的放射科医师分别独立对图像质量进行分析。结果：两名医师对两组肺动脉评分间的差异均无统计学意义（P＞0．05）；两组双肺下叶后基底段肺动脉的评分差异均无统计学意义（P＞0．05）；两组腔静脉的伪影评分差异均有统计学意义（P值均＜0．05）。两组肺动脉主干与左心房、双肺下叶后基底段肺动脉与静脉CT 值的差值差异均无统计学意义（P＞0．05）。结论：标准体重患者宝石CT肺动脉血管成像采用低剂量对比剂联合生理盐水可获得良好的图像，可以满足临床诊断。

Objective：To discuss the feasibility of the reduced contrast dose with saline flushing in pulmonary CT angiography of patients with standard weight with gemstone CT. Methods： According to the contrast dose, 40 patients with standard body weight （BWI 18.5~24.0 kg/m2） undergoing computed tomography pulmonary angiography （CTPA） were randomly divided into 2 groups： reduced contrast was treated with 15mL contrast and 50mL mixed solution （10% contrast and 90% saline） flushing,control group was treated 50mL contrast and 30mL saline flushing. The images were evaluated and analyzed by two experienced radiologists independently. Results：With rank sum test, the grading scores on the manifes tation of the pulmonary artery and the posterior basal segmental pulmonary artery from the two radiologist were not significantly different between the two groups （P〉0.05）. The grading scores on the manifestation of the vena eava from the two radiologists were significantly different between the two groups （P〈0.05）. The differences of CT value between main pulmonary artery and left artium, the posterior basal segmental pulmonary artery and vein from the two radiologists between the two groups were not significantly different （P〉0.05）. Conclusion：The good image quality is obtained with the reduced contrast dose with saline flushing in pulmonary CT angiography of patients with standard body weight with gemstone CT and is satisfied for clinical diagnosis.