CT高浓度碘对比剂在克罗恩病中的应用效果

The Effect of High Iodine Concentration Contrast Media in Crohn’s Disease Patients

目的:通过比较不同浓度碘对比剂在克罗恩患者腹部CT血管成像质量及肠壁相对强化值,探讨高浓度对比剂在该病患者腹部CT的应用价值。方法:回顾性地分析了2016年5月至2019年1月经临床及病理诊断为CD,并进行了小肠CTE检查的30例患者,根据使用对比剂浓度的不同,分为高浓度组(A组碘浓度为400 mg/mL),常规浓度组(B组碘浓度为350 mg/mL)。所有患者通过自动触发技术进行动脉期扫描。动脉期对腹部主要血管显影质量以三级评分为基础进行评价,对腹主动脉、肠系膜上动脉强化及肠壁强化进行以CT值测量为基础的定量评价,计算目标血管的对比噪声比(CNR),采用独立样本t检验对结果进行评价。结果:在定性评价上,动脉期腹部血管成像质量A组高于B组(P<0.05)。定量评价动脉期A组在腹主动脉、肠系膜上动脉强化值均高于B组(P=0.025),且A组在肠壁的动脉期相对强化值(39.25±11.99)HU高于B组(30.27±11.69)HU,差异有统计学意义(P<0.05)。A组目标血管的对比噪声比(CNR)皆高于B组,组间存在统计学差异(P<0.05)。结论:在克罗恩患者中,高浓度碘对比剂对腹主动脉及肠系膜血管主干分支强化程度更高、显影更佳,对病变肠壁强化更明显。

Objective:The purpose of this study was to discuss the effect of high iodine concentration contrast media in patients with Crohn’s disease,by comparing the degree of the image quality of abdominal artery and enhancement of thicken bowel wall by using non-ionic contrast agent of different iodine concentrations.Methods:This study was retrospectively performed in 30 patients with known Crohn’s disease from May 2016 to January 2019 who underwent CTE.They were assigned into two groups according to different iodine concentration injection,high-concentration iodinated contrast medium(Group A,400 mgI/mL)and regular-concentration iodinated contrast medium(Group B,350 mgI/mL).The bolus tracking technique was used to initiate the arterial phase scan.The degrees of image quality were rated on a 3-point scale for qualitative assessment.The computed tomography values of abdominal aorta and Superior mesenteric artery and intestinal wall enhancement were measured for quantitative evaluation,and CNR was computed.The independent t-test was used to compare outcome variables.Results:Group A had significantly higher scores for vascular enhancement image quality(P<0.05).The mean Abdominal aorta and Superior mesenteric artery enhancement was significantly higher in group A than in group B during the arterial phases(P=0.025).Relative enhancement value of intestinal wall in arterial phase was(39.25±11.99)HU and(30.27±11.69)HU,respectively,which group A was high than that of group B.The difference was statistically significant(P<0.05).The CNR of abdominal vascular overall in group A is higher than group B(P<0.05).Conclusion:Our study suggests that,in patient with Crohn’s disease,an increased concentration of iodine improves the image quality of abdominal vascular and its branches,and contributes to a better enhancement in intestinal wall.