头颈部CTA扫描时利用生理盐水注射流率的变化提高图像质量的可行性研究

Influence of using different injection rate of physiological saline to improve image quality in head and neck CTA

目的探讨在头颈部血管CT造影(CTA)检查时利用生理盐水注射流率的变化提高图像质量的可行性。方法选取首都医科大学附属北京友谊医院60例行头颈部血管CT造影检查的患者作为研究对象,随机分为对照组和实验组,每组各30例。扫描方案:100 KV,NI12。注射方案:对照组:先注射优维显370 mg/ml 30 ml,流率3 ml/s,后生理盐水50 ml,流率3 ml/s;实验组:先注射进行优维显370 mg/ml 30 ml,流率3 ml/s,后生理盐水50 ml,流率6 ml/s。采用独立样本t检验比较两组受检者注射侧目标血管(主动脉弓、左右颈总动脉)的CT值。采用Mann-Whitney检验比较两组锁骨下静脉对比剂残留产生的伪影程度。对比两组图像质量。结果目标血管主动脉弓、右颈总动脉、左颈总动脉的CT值对照组分别为288.16±23.88、333.03±28.61、336.53±29.24,实验组分别为364.23±10.11、392.83±58.54、389.13±61.5,实验组CT值均高于对照组,差异有统计学意义(P<0.01);对照组注射侧锁骨下静脉对比剂残留产生的伪影明显多于实验组。两组图像质量的主观评分结果显示对照组优秀5例,较好22例,较差3例;实验组优秀16例,较好14例,较差0例,两组之间差异具有统计学意义(P<0.01)。结论行头颈CTA检查时生理盐水的注射流率是对比剂注射流率2倍时能够提高目标血管的CT值,明显减少注射侧锁骨下静脉内对比剂残留产生的伪影,改善图像质量。

Objective To investigate the improvement of head and neck CT angiography（ CTA） images quality using different injection flow rate of physiological saline. Methods Sixty patients of Beijing friendship hospital performed head and neck CTA were randomly divided into group A（ the control group） and group B（ the experimental group）,30 patients in each group,respectively. Scanning solutions： 100 KV,NI12,injection scheme： group A： Ultravist 370 mg/ml 30 ml,rate 3 ml/s,followed saline 50 ml,rate 3 ml/s; group B： Ultravist 370 mg/ml 30 ml,rate 3 ml/s,followed saline 50 ml,rate 6 ml/s. Independent sample t test were performed to compare the target-vessels（ aortic arch,right left common carotid artery） CT value,Mann-Whitney test were used to compare the artifacts around injected subclavian vein between the two groups.Results Arget-vessels aortic arch,right common carotid artery,left common carotid artery CT value in group A were respectively 288. 16 ± 23. 88,333. 03 ± 28. 61,common carotid artery 336. 53 ± 29. 24,in group B respectively 364. 23 ± 10. 11,392. 83 ± 58. 54,389. 13 ± 61. 5,t value were respectively 6. 9085,5. 021,4. 231,objective CT value in target-vessels was higher in group B than that in group A（ P〈0. 01）. The artifacts around injected subclavian vein in groups A was more significant than that in group B. The score of image quality in group A showed 5 great cases,22 good cases,3 normal cases,in group B,16 great cases,14 good cases,0 normal cases,objective score of image quality in group B was higher than that in group A（ P〈0. 01）. Conclusion Saline injection flow rate twice as much as contrast medium in head and neck CTA is beneficial for reducing the artifacts around injected subclavian vein,improving the imaging quality and gaining higher CT value of target-vessels.