免服泻药管电压切换型双能CT结肠成像泛影葡胺标记肠内容物的研究

Preliminary study on efficacy of fecal tagging with low-concentration and small-dose diatrizoate meglumine in non-cathartic kVp-switching dual-energy CT colonography

目的研究免服泻药管电压切换型双能CT结肠成像低浓度小剂量泛影葡胺标记肠内容物的效果。方法 46例没有影响胃肠道运动功能病史的健康成年志愿者,CT检查前1天低纤维、低残渣饮食,分5次口服4.0%泛影葡胺60mL标记肠内容物,每餐后喝水量大于200mL。采用Toshiba医疗系统Aquilion One 640管电压切换型CT机仰卧位双能容积扫描,获得双能融合图像。统计分析志愿者肠道准备依从性、肠内容物存留状态及肠内容物的1级标记效果。结果 95.7%、4.3%的志愿者肠道准备依从性分别为容易接受、尚可接受。11.2%肠段没有液体和固体内容物存留,44.9%、43.9%肠段分别以液体、固体内容物存留为主。升结肠、横结肠、降结肠内容物的1级标记效果分别为91.3%、100.0%、93.5%,盲肠、乙状结肠、直肠内容物的1级标记效果分别为67.4%、80.4%、73.9%。升结肠、横结肠、降结肠内容物总体上的1级标记效果(94.9%)明显好于盲肠、乙状结肠、直肠内容物总体上的1级标记效果(73.9%),差异有统计学意义(P<0.01)。液体肠内容物的1级标记效果(96.7%)明显好于固体肠内容物的1级标记效果(67.8%),差异有统计学意义(P<0.01)。结论免服泻药管电压切换型双能CT结肠成像低浓度小剂量泛影葡胺对升结肠、横结肠、降结肠内容物及液体肠内容物的标记效果良好。

Objective To preliminarily explore the efficacy of fecal tagging with low-concentration and small-dose diatrizoate rneglumine in non-cathartic kVp-switching dual-energy CT colonography. Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study. One day before CT examination,all volunteers were asked to take low-fiber and low-residue diets;in addition, they were orally administered 60 mL 4% diatrizoate meglumine five times for fecal tagging, followed by drinking 〉200 mL water after each meal. Dual-energy volume scanning was performed on a kVp-switching CT scanner with 135/80 kVp and automatic dose exposure control module in the prone position, and dual-energy blending images were acquired. Compliance with bowel preparation, status of fecal residue,and grade 1 fecal tagging efficacy were analyzed statistically. Results The compliance with bowel preparation was ＂easy to accept＂ in up to 95.7% of volunteers and ＂fairly easy to accept＂ in 4.3 %. The status of fecal remains was ＂without liquid and solid fecal residue＂ ,＂mainly liquid fecal residues＂, and ＂mainly solid fecal residues＂ in 11.2% ,44.9 %, and 43.9 % of colorectal segments, respectively. Grade 1 fecal tagging efficacy was seen in 91.3~, 100G ,and 93.5% of the ascending,transverse and descending colon,respectively;also,it was 67.4% ,80.4%, and 73. 9 % in cecum, sigmoid colon, and rectum. The overall grade 1 fecal tagging efficacy in the ascending, transverse and descending colon was significantly higher than that in cecum, sigmoid colon, and rectum （94.9% vs. 73.9%）, the difference was statistically signifieant（P〈0.01）. The grade 1 fecal tagging efficacy for liquid feces（96.7 %） was significantly superior to that for solid feces （67.8%） ,the difference was statistically significant（P〈0.01）. Conclusion Low-concentration and small-dose diatrizoate meglumine has good fecal tagging efficacy for bowel contents in the ascending, transverse and descending colon, and liquid bowel contents.