高浓度低流速对比剂联合低管电压方案行腹部CT血管成像的可行性

Feasibility of abdominal CT angiography with high concentration and low velocity contrast agent combined with low tube voltage

目的探讨腹主动脉CTA应用高浓度、低流速对比剂注射联合低管电压方案的可行性。方法前瞻性收集430例行腹主动脉CA患者,分为A组(215例)和B组(215例),A组采用碘帕醇(370mgI/mL),剂量400 mgI/kg,流速5 mL/s,管电压120 kV,B组采用碘美普尔(400 mgI/mL),剂量300 mgI/kg,流速4 mL/s,管电压100 kV。比较两组患者图像质量、腹主动脉及分支的CT值,以及有效辐射剂量等指标。结果与A组比较,B组患者肾动脉显示分级及图像质量评分更优,腹主动脉、腹腔干、肠系膜上下动脉及左右肾动脉CT值更高,辐射剂量明显降低(3.94±0.62)vs(12.25±1.19)mSv,注射碘总量更少,对比剂外渗发生率更低,均P<0.05;两组信噪比、对比度噪声比无统计学差异(P>0.05)。结论高浓度低流速对比剂联合低管电压方案可有效降低辐射剂量、注射碘总量及对比剂外渗等风险。

Objective To explore the feasibility of using high concentration and low flow rate contrast agents combined with low tube voltage injection in abdominal aortic CTA.Methods Four hundred and thirty patients with abdominal aortic CT angiography were retrospectively collected and divided into group A(215 cases)and group B(215 cases).Group A was treated with iopamidol(370 mgI/ml)and administered at 400 mgI/kg,with a flow rate of 5 ml/s and a tube voltage of 120 kV.Group B was treated with lomeprol(400 mgI/ml)and administered at 300 mgI/kg,with a flow rate of 4 ml/s and a tube voltage of 100 kV.The image quality score,CT values of abdominal aorta and branches,effective radiation dose,and other indicators between the two groups were compared.Results Compared with Group A,the renal artery vascular display grading and image quality score in group B were better,the CT values of the abdominal aorta,abdominal trunk,superior and inferior mesenteric arteries,and left and right renal arteries were higher,the radiation dose significantly decreased from(3.94±0.62)to(12.25±1.19)mSv(P<0.05),the total amount of iodine injected was less and the incidence of contrast agent extravasation was lower,all P<0.05.There was no statistical difference in signal-to-noise ratio and contrast-to-noise ratio between the two groups(P>0.05)Conclusions The combination of high concentration,low flow rate contrast agent and low tube voltage scheme can effectively reduce the risk of radiation dose,total injected iodine and contrast agent extravasation.