下肢CT血管成像对比剂注射方案的优化

The optimization of contrast media injection protocol in lower extremity CTA

目的 比较两种不同CT血管成像对比剂注射方案在下肢血管成像的应用效果。方法 59例下肢闭塞性动脉硬化患者,随机分为传统组（采用单筒注射器对比剂注射方案,速度4.0～4.5ml/s,对比剂用量130～140ml,留置针为一次性使用留置针18G）和改良组（注射为30例,采用双筒注射器对比剂注射,并追加生理盐水方案,速度为3.2～3.5ml/s,对比剂用量90ml,生理盐水用量40ml,连续无间断注射,留置针为一次性使用留置针20G）,采用自定标准,盲式评估方法对两组扫描方案下的图像质量及安全可靠性进行评估比较。结果 通过CT三维重建后得出改良的扫描方法下肢远端血管的显影比传统的方法图像更为清楚、更安全可靠性。改进方案注射后的扫描图像质量能达到医学影像诊断要求,差异有统计学意义（P〈0.05）。结论 下肢CT血管成像采用改良的注射方案进行扫描能提高图像质量,可作为下肢CT血管成像检查的常规检查。

Objective To compare the enhancement of CTA scanning program of lower limbs and the quality of reconstruction images using different contrastmaterials injection protocols on Gemstone CT. Methods Fifty-nine patients were randomly divided into 2 groups： one group was subjected with traditional injection project（ adopt single syringe contrast inject, flow rate was 4. 0 -4. 5 ml/s, volume 130 - 140 ml, 18G venous indwelling needle） and the other group was injected with the modified project（ adopt double tube injector contrast inject, the end phase of contrast agent injection with saline injection, the flower rate of contrast agent is 3.2 - 3.5 ml/s, the dosage is 90 ml, the dosage of saline is 40 ml, the phases injection were not discontinues, 20G venous indwelling needle）. The image quality was evaluated with blind method. Results After comparing the images of distal lower extremity vas- cular acquired with two scanning solutions, the vascular images with modified program were better and more reliable than that produced with traditional project. Conclusion The modified injection project image mass is more effective than traditional injection project and satisfy the needs or requirements of clinic diagnoses.