前瞻性探讨小剂量对比剂及特殊体位设计在320排CT颈部血管造影中的应用

Prospective Study of Low-Dose Contrast Agent and Special Position Design in 320-Slice CT Neck Angiography

【目的】探讨小剂量对比剂及特殊体位设计在320排CT颈部血管造影中的可行性研究。【方法】收集临床可疑颈动脉或椎动脉病变的患者60例,将其随机分为两组G1、G2,每组各30例,检查前均先询问体质量并做记录。两组均采用320排CT螺旋扫描模式,检查前均于右臂肘静脉留置静脉通道,对比剂用量为体质量乘以0.6 m L/kg,注射对比剂速率均为4 m L/s。G1组:采用常规体位;G2组:采用辅助设备使手臂抬高并小角度外展的体位,其他扫描及重建参数与G1组相同。测量颈动脉和颈静脉各节段CT值,观察颈动脉(包括颈总动脉、颈内/外动脉)、椎动脉的显示效果及头臂静脉、上腔静脉、右侧锁骨下静脉污染程度。比较和分析两组客观图像质量(血管CT值)。【结果】G1、G2两组右头臂静脉、右锁骨下静脉和上腔静脉CT值比较,差异有统计学意义(P<0.05)。G1、G2两组颈总动脉开口处;左、右颈内动脉(窦部上2 cm);左、右侧椎动脉窦部水平的CT值比较,差异无统计学意义(P>0.05)。【结论】在行颈部CTA检查时,采用低剂量对比剂及特殊体位扫描,图像质量能够满足临床诊断需要;同时提高了对比剂利用效率,降低了对比剂的肾毒性风险。

【Objective】To investigate the feasibility of low-dose contrast agent and special position design in 320-slice CT neck angiography.【Methods】Sixty patients with clinically suspected carotid or vertebral artery lesions were enrolled. They were randomly divided into two groups of G1 and G2,with 30 cases in each group. Body weight was measured and recorded before examination. 320 rows CT helix scan mode was used in both groups. Preventive intravenous access was given to the cubital vein of the right arm[1]before the test. The contrast medium dosage was 0.6 m L/kg and the contrast agent injection rate was 4 m L/s. Group G1：used conventional position;Group G2：used auxiliary equipment to elevate the arm and angle outstretched position[2]. The other scanning and reconstruction parameters were the same as those in group G1. The CT values of each segment of the carotid artery and jugular vein were measured. The carotid artery（including the common carotid artery,internal and external carotid artery）and vertebral artery were observed and the degree of pulmonary vein damage,superior vena cava and right subclavian vein were observed. Comparing and analyzing objective image quality（vascular CT value）between the two groups.【Results】 The CT values of right brachiocephalicvein,right subclavian vein and superior vena cava in in G1 and G2 groups were statistically significant（P0.05）. There were no significant differences in the CT values of the left and right vertebral sinus between the two groups（G1 and G2）,the left and right internal carotid arteries（2 cm on the sinuses）,and no significant difference（P0.05）.【Conclusion】During the neck CTA examination,Low dose contrast agent and special postural scanning can be used to meet the needs of clinical diagnosis. At the same time,the utilization efficiency of Contrast agent media is increased and the nephrotoxicity of Contrast agent media is reduced.