分时相低对比剂注射方案在颅内动脉瘤三维-数字减影血管造影成像的应用

Application of Phase-Division Low-Dose and Low-Flow Contrast Agent in Three-Dimensional-Digital Subtraction Angiography Imaging of Intracranial Aneurysms

目的 探讨分时相低剂量低流率对比剂注射方案在颅内动脉瘤三维(three-dimensional,3D)-数字减影血管造影(digital subtraction angiography,DSA)成像的临床应用价值。方法 前瞻性连续收集经计算机断层扫描血管成像(CTA)/磁共振血管造影(MRA)检查疑似或确诊颅内动脉瘤患者共69例,按照交替序贯将患者分实验组35例,常规组34例,统计分析两组患者动脉瘤成像评分、旋转造影辐射剂量及栓塞效果。结果 实验组与常规组三维重建成像对颅内动脉瘤的细节显示比较,差异无统计学意义(P=0.633)。两组间患者辐射剂量空气比释动能(air kerma,AK)、剂量-面积乘积(dose-area product,DAP)比较,差异均无统计学意义(P=0.176,P=0.765)。两组患者间栓塞效果比较,差异无统计学意义(P=0.111)。实验组患者行3D-DSA使用对比剂剂量显著少于常规组,差异有统计学意义[(9.29±0.86)mL vs.(18.00±0.00)mL,P<0.01]。结论 分时相低对比剂注射方案在颅内动脉瘤患者3D-DSA成像安全有效,应用该方案能显著减少患者的对比剂使用剂量。

Objectives To investigate the clinical value of phase-division low-dose and low-flow contrast agent injection scheme in three-dimensional(3D)-digital subtraction angiography(DSA)imaging of intracranial aneurysms.Methods A total of 69 patients with suspected or confirmed intracranial aneurysm by computed tomography angiography(CTA)/magnetic resonance angiography(MRA)examination were prospectively and consecutively collected,and the patients were divided into experimental group(n=35)and routine group(n=34)according to the alternating sequence.The aneu-rysm imaging score,the radiation dose of rotational angiography and embolization effect of the two groups were statistically analyzed.Results There were no significant differences in the details of intracranial aneurysm,radiation dose and embolization effect between the two groups(P>0.05).There were no significant differences of air kerma(AK),dose-area product(DAP)between the two groups(P=0.176,P=0.765).There was no significant difference in embolism effect between the two groups(P=0.111).The contrast agent dose used by 3D-DSA in experimental group was significantly lower than that in conventional group[(9.29±0.86)mL vs.(18.00±0.00)mL,P<0.01].Conclusions The phase-division low-dose and low-flow contrast agent injection scheme is safe and effective in 3D-DSA imaging of intracranial aneurysms.Application of this scheme can reduce the dose of contrast agent that used during 3D-DSA imaging.