冠状动脉造影术中造影剂个性化注射法的应用

Application of personalized contrast injection method in coronary angiography

目的：比较临床传统造影剂注射方案与个性化注射方案于64排螺旋 CT 心脏冠脉（CTA）造影中图像的质量差异，得出最佳 CTA 造影剂注射方案。方法选取需行 CTA 造影的患者64例，将其以数字表法随机分为观察组及对照组，每组32例。对照组行常规临床造影剂注射方案进行造影，观察组行个性化造影剂注射方案，对比两种造影剂注射方案所得的图像质量差异。结果与对照组相比，观察组患者右心室（RV）及肺动脉 CT 值升高明显[（272．4±72．3）HU、（372．1±78．2）HU]，差异有统计学意义（t ＝3.827、3．921，P ＜0.05）；两组患者左心室（LV）、升／降主动脉 CT 值间差异无统计学意义（P ＞0．05）；与对照组室间隔成像情况对比，观察组优势明显（对照组3分者20例，观察组29例），差异有统计学意义（χ2＝16.023，P ＜0．05）。结论于 CTA 造影中，个性化造影剂注射速度可将右心的强化程度有效地提高，使右心室室间隔成像更为清晰，为临床诊断及预后提供了极大便利，值得于临床中进一步推广应用。

Objective To investigate the image quality differences of clinical conventional contrast injection solutions and personalized injection program in 64 -slice spiral coronary CT angiography （CTA）,thus to obtain the CTA optimum contrast agent injection protocol.Methods 64 patients who needed to receive CTA angiography,were randomly divided into observation group and control group,32 cases in each group.The control group underwent rou-tine clinical angiography contrast agent injection protocol,the observation group received personalized contrast injec-tion solutions,the image difference of the two groups was compared.Results Compared with the control group,the right ventricular （RV）and pulmonary CT value of the observation group increased significantly[（272.4 ±72.3）HU, （372.1 ±78.2）HU],the differences were statistically significant （t =3.827,3.921,all P〈0.05）.CT values of left ventricular （LV）,ascending /descending aorta had no significant differences between the two groups （P〉0.05）. Compared with the control group,the advantages of septal imaging of the observation group was significant （control group 3 points in 20 cases,29 cases of the observation group）,the difference was statistically significant （χ2 =16.023,P〈0.05）.Conclusion In CTA angiography,personalized contrast injection speed can effectively improve the enhancement degree of right heart,so that the right ventricular septal has clearer image,provides a great conven-ience for clinical diagnosis and prognosis,it is worth further clinical application.