64排CT多期双流混合注射跟踪法在肺动脉成像中的应用

Dual-flow multiphase injection technique with contrast medium-saline mixture for pulmonary angiography using 64-row multidetector computed tomography

目的:探讨64排螺旋CT多期双流速混合对比剂注射跟踪法在肺动脉成像(CTPA)中的可行性。方法:将50例拟诊为肺动脉栓塞(PE)的患者随机分为2组,A组使用混合注射(对比剂与生理盐水配比1∶4)跟踪法,B组使用预注射时间-密度曲线法。采用双盲法评价2组的CTPA图像质量,测量肺动脉主干及主要分支的CT值并进行统计学分析。结果:除1例患者未获得时间-密度曲线外,余49例患者均获得较满意的CTPA图像质量,两种方法间图像质量评分的差异无统计学意义(P>0.05)。两组中肺动脉主干及分支均显示清晰,其血管腔内的CT值在2组间的差异较小且无统计学意义(P>0.05)。结论:多期双流速混合注射跟踪法CTPA具有对比剂用量小、辐射剂量小、图像质量可与传统的预注射跟踪法相媲美、且受心功能影响较小、操作简单易行等优点,值得在临床工作中广泛推广。

Objectire：To evaluate the feasibility of multiphase dual-flow injection technique with contrast medium-sa-line mixture in pulmonary angiography using 64-row multi-detector computed tomography.Methods：50 patients with sus-pected pulmonary embolism were randomly divided into two groups,injection of a contrast medium-saline mixture （1 ∶4） with bolus tracking method was used in group A and the pre-injection method with time-density curve technique was used in group B.Double-blind method was used to evaluate the image quality of the two techniques,the CT value in main trunk and proximal branch fo pulmonary artery was measured,and the results were analyzed statistically.Results：Except one case in the group B was failed to obtain time-density curve,49 patients had satisfactory CTPA image quality.There was no signifi-cant difference in the score of image quality between the two groups.The main trunk and proximal branch of pulmonary ar-tery were demonstated clearly on CTPA images in the two group,with no statistic difference of the CT value in blood ves-sels between the two groups （P〉0.05）.Conclusion：Multiphase dual-flow injection technique with contrast-saline mixture can be recommended to be applied in CTPA examination due to its excellent image quality similar to that of conventional pre-injection method but with less contrast medium and lower radiation.