不同对比剂注射速率对头颈CT血管成像质量及受检者安全性的影响

Impact of contrast medium injection rates on imaging quality and recipient safety during head and neck Computed Tomography angiography

目的 探讨不同对比剂注射速率对头颈CT血管成像(CTA)成像质量及受检者安全性的影响。方法 选取2019年6月至2021年6月我院收治的90例需进行头颈CTA的患者作为研究对象,采用随机数字表法分为A组和B组,各45例,2组均注射对比剂总量70 ml进行头颈部CTA检查,A组对比剂注射速率为5 ml/s,并以5 ml/s追加注射70 ml 0.9%氯化钠注射液,B组对比剂注射速率为4 ml/s,并以4 ml/s追加注射70 ml 0.9%氯化钠注射液,比较2组CTA辐射剂量、安全性、图像质量。结果 2组噪声、管腔边缘锐利度主观评价得分相比差异无统计学意义(P>0.05),A组对比度、图像清晰度主观评价得分高于B组(P<0.05);2组颈动脉分叉、主动脉弓信号噪声比(SNR)、平均CT值差异无统计学意义(P>0.05),A组颈动脉分叉、主动脉弓对比噪声比(CNR)值高于B组(P<0.05);2组患者扫描后剂量长度乘积(DLP)、容积CT剂量指数(CTDIvol)、有效剂量(ED)差异无统计学意义(P>0.05);2组患者扫描后,A组患者不良事件发生率低于B组(P<0.05)。结论 对比剂5 ml/s注射速率下头颈部CTA检查成像质量更好,且受检者安全性更高。

Objective To investigate the impact of contrast medium injection rates on imaging quality and recipient safety during head and neck computed tomography angiography(CTA).Methods A total of 90 patients admitted to our hospital and undergoing head and neck CTA between June 2019 and June 2021 were included as study subjects,divided into groups A and B by random number table(n=45 each).The total dose of contrast medium was 70 ml for each head and neck CTA examination,injected at 5 mL/s and followed by a normal saline chase of 70 ml(5 ml/s)in group A,or injected at 4 ml/s and followed by a normal saline chase of 70 mL(4 ml/s)in group B.The two groups were compared on radiation dose,safety and imaging quality of CTA.Results There was no significant difference in scores of subjective evaluation on noise and lumen edge clarity between the two groups(P>0.05);however,the group A showed higher subjective evaluation scores for image contrast and sharpness than those in group B(P<0.05).There were no significant differences in the signal-to-noise ratios(SNR)and mean CT values of carotic bifurcation and aortic arch between groups(P>0.05),but the contrast-to-noise ratios(CNR)of carotid bifurcation and aortic arch were higher in group A than those in group B(P<0.05).There were no significant differences in dose-length product(DLP),volume CT dose index(CTDI-vol),and effective dose(ED)between the two groups after scanning(P>0.05).The incidence of adverse events post-CTA was lower in group A than in group B(P<0.05).Conclusion Better imaging quality and higher recipi-ent safety during head and neck CTA can be achieved with a contrast medium injection rate of 5 mL/s.