超重人群冠状动脉血管成像检查中四种注射技术减少对比剂用量的差异性研究

Comparative study on four injection methods reducing contrast volume in the coronary CTA of overweight people

目的运用智能法、ml/kg法、改良ml/kg法和固定量法4种方法,比较在超重人群冠状动脉CTA中减少对比剂用量的差异性。方法选取符合纳入标准的病例180例,相应分为智能组、ml/kg组、改良组和固定量组(记作A、B、C、D)。以冠状动脉9个节段即RCA近、中、远段,LM,LAD近、中、远段,LCX近、远段为兴趣区,对图像质量进行评分、测量增强后血管腔内CT值,记录4组冠状动脉≤1.5 mm小动脉显示情况。结果 4组临床资料比较无统计学差异,对比剂用量具有统计学差异(P<0.05),分别为(67.60±6.10)ml、(61.15±6.01)ml、(51.15±6.72)ml、70 ml,4组冠状动脉目标血管强化水平无明显差异(P>0.05)。对于≤1.5 mm小动脉显示数目393个,清晰度为95.15%。9个冠状动脉节段主观评价和客观评价不具有统计学意义(P>0.05),结果一致。结论改良ml/kg法比ml/kg法可减少超重肥胖人群约10 ml对比剂用量,在4种方法中以改良ml/kg法在大体重超重肥胖人群降低用量显著,图像质量能满足诊断需要,具有一定的可行性。

Objective To use smart method,four methods ml/kg,modified ml/kg method and fixed amount method in coronary CTA of overweight and obese people so as to compare the reduced contrast agent volume differences. Methods The 180 patients met the inclusion criteria correspondingly was divided into intelligent group,ml/kg group,improved ml/kg group and a fixed volume set （denoted by A,B,C,D）. For coronary nine segments named as RCA near,middle,distal,LM,LAD proximal,middle,distal,LCX proximal and distal segments of the region of interest,the image quality score,endovascular enhanced CT value measurement and recording four groups coronary ≤1.5 mm small arteries display ease were taken. Results There was no significant difference between the four group＇s clinical data;the volume of contrast agent had a statistically significant difference （P〈 0.05）,i. e （67.60±6.10）ml, （61.15±6.01）ml, （51.15±6.72）ml and 70 ml. In 5 coronary artery strengthen target group level had no significant difference （P〉0.05）. That ≤1.5 mm small arteries showed the number 393,the clarity was 95.15% ;The 9 coronary segments subjective and objective evaluation had not any statistically significant difference （P〉0.05）,i. e consistent results. Conclusion The improved ml/kg method can reduce the dosage about 10ml contrast of overweight and obesity than ml/kg,in the four methods the improved ml/kg has the most significant reduction of the volume,but image quality can meet the diagnostic needs thus having some feasibility.