对比剂稀释法在低体重新生儿先天性心脏病CT血管成像中的应用

Application of Contrast Mediumdilution in CT Angiography of Congenital Heart Disease in Low Weight Newborns

目的探讨对比剂稀释法在低体重新生儿先天性心脏病CT血管成像(CTA)中的应用可行性。方法前瞻性选取来本院行心脏CTA检查3~28天患有先天性心脏病新生儿100例,随机分为研究组、对照组(每组50例);对照组患儿使用未稀释对比剂威视派克(2 ml/kg体重);研究组患儿使用稀释浓度为60%对比剂威视派克(3 ml/kg体重);所有新生儿体重均在2.5 kg以下;所有新生儿扫描参数、使用对比剂型号、对比剂注射参数均一致;对比分析两组患儿主动脉弓、降主动脉、肺动脉干等处CT值,对比分析两组患儿图像质量主观评价结果、图像信噪比(SNR)、对比噪声比(CNR)等,对比分析两组患儿接受的有效辐射剂量(ED)及注入体内对比剂剂量。结果对照组患儿主动脉弓、降主动脉、肺动脉干等处CT值高于研究组(P<0.05),对照组患儿注入体内对比剂剂量高于研究组(P<0.05),对照组患儿图像SNR、CNR、图像主观评价结果高于研究组(P<0.05);两组患儿ED无明显差异(P>0.05)。结论对比剂稀释法应用在低体重新生儿先天性心脏病CTA中,在不影响临床诊断条件下,能降低患儿对比剂使用量,提高检查成功率,具有临床意义。

Objective To explore the application feasibility of contrast media dilution in CT angiography of congenital heart disease in low weight newborns. Methods A total of 100 newborns(3-28 days) with congenital heart disease who came to our hospital for cardiac CT angiography examination for were selected and randomly divided into study group and control group(50 in each group);the control group was treated with undiluted contrast agent Visipaque(2 ml/kg);the study group was treated with dilute concentration of 60% contrast agent Visipaque(3 ml/kg).The body weight of all newborns were less than 2.5 kg, and the scanning parameters, the type of contrast medium used and the injection parameters of contrast medium were consistent;the CT values of aortic arch, descending aorta and pulmonary artery trunk of the two groups were compared and analyzed, the subjective evaluation results of image quality, image signal-to-noise ratio and contrast signal-to-noise ratio of the two groups were compared and analyzed, the effective X-ray radiation dose and contrast agent dose injected into the body of the two groups were compared and analyzed. Results The CT values of aortic arch, descending aorta and pulmonary artery trunk in the control group were higher than those in the study group(P<0.05),the dose of contrast agent injected into the body in the control group was higher than that in the study group(P<0.05),and the image signal-to-noise ratio, contrast signal-to-noise ratio and image subjective evaluation results in the control group were higher than those in the study group(P<0.05);there was no significant difference in X-ray radiation dose between the two groups(P>0.05). Conclusion The application of contrast medium dilution method in CT angiography of congenital heart disease in low weight newborns can reduce the use of contrast medium and improve the success rate of examination without affecting the clinical diagnosis.