对比剂注射部位对儿童复杂先天性心脏病双源CT成像的影响

Effect of injection site of contrast media on quality of dual-source CT angiography in children with complex congenital heart disease

目的探讨对比剂注射部位对儿童复杂先天性心脏病CTA图像质量的影响。方法回顾性分析426例复杂先天性心脏病患儿的双源CT心脏大血管CTA图像,其中经上肢静脉注射154例(A组),以下肢静脉注射272例(B组),对A、B组CTA图像上腔静脉对比剂硬化束伪影,心腔、大血管CT值,右心房、右心室对比剂均匀度,心内结构及大血管显示清晰度进行对比。结果 A组图像上腔静脉内对比剂硬化束伪影评分为3.00±1.04,B组为3.96±1.08,优于A组,二者差异有统计学意义(P<0.01),两组心腔、大血管平均CT值的差异均无统计学意义(P均>0.05);两组心内结构、大血管、冠状动脉起源及近段图像清晰度主观评分差异均有统计学意义,B组均高于A组(P均<0.05),而右心房、右心室对比剂均匀度评分的差异无统计学意义(P均>0.05)。结论对比剂注射部位的选择对儿童先天性心脏病CTA图像质量有显著影响,经下肢浅静脉注射对比剂有助于消除上腔静脉对比剂伪影,提高图像质量。

Objective To explore the effect of injection site on quality of the CTA image in children with complex congen- ital heart disease （CHD）. Methods The imaging of 426 children with complex CHD who underwent the dual-source CT angiography were analyzed retrospectively. Contrast media were injected through vein of the upper limp in 154 children （group A）, and through vein of the lower limp in 272 children （group B）. The specific content were compared, i.e. the image artifacts of superior vena cava （SVC）, CT values of cardiac chambers and great vessels, the homogeneity of contrast media in the right ventricular chambers and the right atriums, the visual quality of cardiac structure and great vessels. Re- suits The score for the image artifacts of SVC in group B （3.96±1.08）, was better than that in group A （3.00±l. 04）, the difference was statistically significant （P〈0. 01）. The CT values of cardiac chambers and great vessels between the two groups had no statistical significance （all P〉0.05）. The image clarity of cardiac structure, great vessels, and the origin and proximal segment of coronary arteries in group B was better than that in group A, there were statistical differences be- tween the two groups. The homogeneity of contrast media in the right ventricular chambers and the right atriums between the two groups had no statistical significance （both P〉0.05）. Conclusion The injection site of contrast media has signifi- cant impact on the quality of the CTA image among children with complex CHD, the lower limp vein injected contrast media effectively eliminated the image artifacts of SVC and improve the image quality.