碘对比剂在下肢深静脉CT成像中的应用和技术要点

The application and technical essential of CT with iodine contrast agent in the lower extremity deep vein

目前,CT扫描技术已成为诊断下肢深静脉血栓的重要影像手段。由于下肢静脉独特的解剖学特点,获得高质量静脉CT血管影像尚有一定难度,目前临床应用的间接静脉法、直接静脉法及双向法等多种CT检查技术亦均有其各自的局限性。因此,如何安全、合理使用碘对比剂,以提高下肢深静脉管腔内对比剂浓度的同时减少伪影,并通过降低碘对比剂的用量防止对比剂急性肾损害的发生,一直是临床上关注的热点问题。现就不同CT检查方法的技术要点以及碘对比剂用量、注射流率、浓度及温度等参数的应用策略予以综述。

At present, CT scanning technology has become an important tool in diagnostic imaging of lower extremity deep vein thrombosis. Based on the unique anatomical characteristics of the lower extremity venous, acquiring high-quality vein CT angiography image still has certain difficulty. At present, indirect method, direct method, and two-way method still have some disadvantages. Iodine contrast agent should be used safer and more reasonable to raise the concentration of contrast medium in the lower extremity deep venous lumen. At the same time we should reduce the artifacts and dosage of the iodine contrast agent to prevent contrast-induced acute kidney injury. All of these are hot topics in clinic. In this paper, we reviewed the different technical essentials of CT examination, the dosage of iodine contrast agent, injection flow rate, concentration, and temperature.