基于肾体积的个体化碘对比剂方案在腹部CT增强中的应用

The application of an individualized iodine contrast agent scheme based on kidney volume in abdominal CT enhancement

目的:探讨基于肾体积计算碘对比剂用量的个体化方案在腹部CT增强中的可行性及其价值。方法:依据纳入与排除标准,前瞻性地连续搜集行腹部CT增强扫描的154位患者为研究对象,根据对比剂用量的不同计算方法将其随机分为3组,即肾体积组、肝体积组和体表面积组,根据相应公式计算对比剂剂量行腹部CT增强检查,统计分析3组间碘对比剂用量及图像质量;同时搜集研究对象的相关临床基线资料。结果:①图像评价的一致性。采用Kappa一致性检验对两名腹部影像中级职称医生图像质量评分的一致性进行评价,结果显示一致性较好(Kappa值=0.65)。②平均图像质量评分:肾体积组图像质量较好59例(100%),肝体积组图像质量较好46例(97.9%),体表面积组图像质量较好48例(100%),成对比较时,3组患者图像质量之间不存在统计学差异,均达到临床诊断要求。③碘对比剂用量:肾体积组对比剂用量(53.87±7.17)mL,肝体积组对比剂用量(78.65±5.45)mL,体表面积组对比剂用量(85.84±9.46)mL,成对比较时,3组患者碘对比剂用量之间存在统计学差异(P<0.01),其中以肾体积组对比剂用量最低。结论:基于肾体积计算的个体化对比剂用量在腹部CT增强检查中具有可行性且用量降低。

Objective:To explore the feasibility and value of an individualized iodine contrast agent scheme that the dosage is calculated according to renal volume while abdominal CT enhancement.Methods:According to the inclusion and exclusion criterias,154 patients who underwent abdominal CT enhancement examination at Affiliated Hospital of Guizhou Medical University were enrolled.They were randomly divided into kidney volume group,liver volume group and body surface area group.The contrast agent dosage of each group was calculated according to the corresponding formula.The difference of the abdominal image quality and dosage of iodine contrast agent of each group were analyzed.Results:①Consistency of image evaluation:Kappa consistency test was used to evaluate the consistency of image quality scores of two doctors with intermediate titles in abdominal imaging.The results showed that the consistency was middle(Kappa value=0.65).②Average image quality score:high quality image percentage of the renal volume group,the liver volume group and the body surface area group were 100%(59/59),97.9%(45/46)and 100%(48/48)respectively.There was no statistical difference among the three groups.All of the image of three group were met the requirements of clinical diagnosis.③Contrast media dosage of iodine:the dosage of contrastagent of the kidney volume group,the liver volume group and the body surface area group was(53.87±7.17)mL,(78.65±5.45)mL and(85.84±9.46)mL respectively.The difference in pairwise comparison among the three groups was statistically significant(P<0.01).The dosage of iodine contrast agent of the kidney volume group is the lowest.Conclusion:It is feasibility in abdominal CT enhancement with the individualized scheme based on the kidney volume.It decrease the dosage of iodine contrast agent.