肝脏DECT成像中对比剂碘浓度对富血供肝细胞癌显示的影响

Effect of Different Iodine Concentrations of Contrast Medium on the Conspicuity of Hypervascular Hepatocellular Carcinoma during Liver Dual-energy CT

目的根据体表面积(body surface area,BSA)调整碘剂量(17.1 g I/m2BSA)、固定对比剂注射时间(25s),比较肝脏双能量CT(dual-energy CT,DECT)增强扫描中两种不同碘浓度对比剂对富血供肝细胞癌(Hepatocellular carcinoma,HCC)显示的影响。方法 300例病人被随机分为2组,A组注射300mg I/m L对比剂,B组注射370mg I/m L对比剂,碘剂量根据BSA调整,对比剂注射时间固定为25s。68例病人共83个病灶被证实为富血供HCC。在肝动脉晚期80kVp、140 kVp或彩色碘覆盖图中,比较高、低碘浓度对比剂间肿瘤-肝脏对比噪声比(tumor-to-liver contrastto-noise ratio,TLCNR)。结果 80kVp图像中A、B两组平均TLCNR分别为(3.46±1.41)、(2.97±1.14)(P=0.08);140kVp图像中A、B两组平均TLCNR分别为(0.89±0.75)、(0.87±0.70)(P=0.92);彩色碘覆盖图中A、B两组平均TLCNR分别为(5.21±1.93)、(5.49±2.21)(P=0.53)。每个系列图像中,A与B两组间平均TLCNR差异没有统计学意义(P>0.05)。结论在肝脏增强DECT成像中,根据BSA调整碘剂量,固定注射时间,300 mg I/m L与370 mg I/m L对比剂间富血供HCC显示的清晰度差异无显著意义。

Objective To compare the effects of contrast medium with two different iodine concentrations（iopamidol 300 mg I/m L and 370 mg I/m L） on the conspicuity of hypervascular hepatocellular carcinoma（HCC） during dual-energy CT（DECT） of the liver, use of a protocol with iodine dose adjusted for the patient＇s body surface area（BSA, 17.1 g I/m2BSA） and fixed injection duration（25s）. Methods 300 patients were prospectively randomized into two groups. Patients in group A received iopamidol with an iodine concentration of 300 mg I/ml, B received iopamidol with an iodine concentration of 370 mg I/ml respectively. Iodine dose was adjusted according to BSA, with a fixed injection duration of 25 s. Sixty-eight patients had 83 hypervascular HCCs. Dual-energy acquisition mode was performed during late hepatic-arterial phase. Image quality and the tumor-to-liver contrast-to-noise ratio（TLCNR） were compared between higher-concentration contrast medium and lower-concentration contrast medium at 80-and 140-kVp and color iodine overlay images. Resutlts Mean TLCNR at 80 kVp were（3.46±1.41） for group A and（2.97±1.14） for group B（P=0.08）; mean TLCNR at 140 kVp were（0.89±0.75） for group A and 0.87±0.70 for group B（P=0.92）, mean TLCNR at color iodine overlay images were（5.21±1.93） for group A and（5.49±2.21） for group B（P=0.53）. Quantitative analysis did not show significant differences between groups（P0.05） at At 80-or 140-kVp or color iodine overlay images. Conclusion With fixed injection duration（25 s） and iodine load being tailored according to BSA, comparable conspicuity of hypervascular HCC can be achieved with 300 mg I/ml and 370 mg I/ml being injected at contrast-enhanced DECT imaging of the liver.