DSCT肺静脉成像技术的对比分析研究

Clinical study of the pulmonary vein with DSCT

目的采用双源CT(dual source computed temography,DSCT) bolus tracking及test bolus两种增强方法分别进行肺静脉增强扫描,探讨两种增强方案的优缺点。方法随机选取昆明医学院第一附属医院接受DSCT胸部增强扫描的受检者190例,分为A、B两组,A组130例行bolus tracking技术扫描,B组60例行test bolus技术扫描,分别用肺静脉、肺动脉及肺动静脉差值的定量评定法及目测图像质量的5分定性评价法,评价肺静脉成像质量的差别,并比较对比剂用量和增强时间。结果 A组肺静脉、肺动脉及动静脉差值分别为(159. 77±70. 70) HU、(344. 11±99. 38) HU、(189. 16±86. 20) HU; B组肺动脉、肺静脉及动静脉差值分别为(179. 47±51. 63)、(365. 50±94. 05)、(189. 744±83. 26) HU;两种方法肺静脉成像质量无显著差异(两组资料比较肺动脉F=3. 74,P> 0. 05,肺静脉F=1. 967,P> 0. 05,动静脉差值F=0. 020,P> 0. 05)。两组图像质量目测评分无统计学差异(Z=-1. 06,P> 0. 05)。A组和B组对比剂总量为60和70ml,生理盐水用量为30和50ml。A组增强扫描所需时间(34. 81±2. 19) s,B组(97. 10±1. 68) s,A组平均减少62. 29s/例(t’=-214. 73,P <0. 001)。结论 DSCT bolus tracking及test bolus两种增强方案均能用于CT肺静脉增强扫描,两者肺静脉成像效果无差异,可获得清楚显示3级以上至6级肺静脉的优质图像,而且成功率达98. 5%。但test bolus操作较复杂,所需对比剂量及生理盐水稍多,扫描所需时间较长。

Objective To discuss the effects of two kinds of enhanced CT scan of pulmonary vein respectively using blous tracking and test-blous with dual source CT. Methods 190 patients accepted DSCT enhanced chest scan in the First Affiliated Hospital of Kunming Medical College were divided into Group A and B; 130 patients in group A were conducted blous tracking, while 60 subjects from group B were implemented in test-blous. Then, we used the quantitative evaluation method of pulmonary vein, pulmonary artery and pulmonary arteriovenous difference and 5-point qualitative evaluation method of image quality by the eye for estimating the image quality and contrasting the dosage of contrast agent and the enhanced scan time. Results Group A：the average CT values of pulmonary vein, pulmonary artery and pulmonary arteriovenous difference were （159.77±70.70） HU, （344.11±99.38） HU, （189.16±86.20） HU; Group B：the average CT values of pulmonary artery, pulmonary vein and pulmonary arteriovenous difference were （179.47±51.63） HU, （365.50±94.05） HU, （189.744±83.26） HU; there was no significant difference in imaging quality between two kinds of enhanced pulmonary vine CT scan （compared two sets of data, pulmonary artery F =3.74, P 〉 0.05, pulmonary vein F =1.967, P 〉0.05 and pulmonary arteriovenous difference F =0.020, P 〉0.05）. The scores of image quality of two groups were no significant differences （ Z =-1.06, P 〉0.05）. The dosage of contrast agent were respectively 60 and 70 ml in group A and group B, while the dosage of normal saline was 30 and 70 ml. The enhanced scan time was （34.81±2.19） s in group A and （97.10±1.68） s in group B, so 62.29 s was saved in group A （ t ＇=-214.73, P 〈0.001）. Conclusion Bolus tracking and test bolus can be used for the enhanced CT scan of pulmonary vein and both of them had no different imaging effect, which can show more than three to six high-quality images of pulmonary vein clearly and the success rate was 98.5%. But the latter one needed more contract agent, saline and scan time.