64排螺旋CT头颈部血管成像图像质量优化的应用研究

Application of Image Quality Optimization with the 64-Row Spiral CT Angiography in Head and Neck arteries

目的 探讨小剂量团注测试技术结合双流注射技术在64排螺旋CT头颈部血管成像(CTA)中的应用价值。方法 选取2019年5月至2023年6月来我院检查的120例头颈部CTA成像患者,随机分为A、B组,每组各60例。A组采用对比剂团注追踪技术,B组采用小剂量团注测试技术联合双流注射技术,两组分别进行头颈部CTA成像,对两组图像质量进行主观、客观评分,并对两组对比剂使用情况进行比较。结果 两组图像大部分都能满足诊断,头颈部较大血管能清楚显示,但B组脑血管边缘分支显示更清楚,脑静脉污染较少,因此两组图像质量主观评分B组高于A组(P<0.05)。两组图像主动脉弓、左颈总动脉分叉部、左颈内动脉虹吸部、左大脑中动脉M1段、左大脑后动脉P1段、左椎动脉起始部的CT值比较,差异无统计学意义(P>0.05);两组图像客观评分,主动脉弓、左颈总动脉分叉处及左大脑中动脉M1段的图像噪声、信噪比(SNR)、对比信噪比(CNR)比较,差异无统计学意义(P>0.05);两组对比剂使用量比较,B组低于A组(P<0.05)。结论 64排螺旋CT头颈部血管成像采用小剂量团注测试技术联合双流注射技术较常规对比剂团注追踪技术更能获得稳定、优良的图像质量,同时对比剂用量显著减少,具有临床推广价值。

Objective To investigate the value of low dose test-bolus combined with dual flow technique with the 64-row spiral CT angiography(CTA)in head and neck arteries.Methods One hundred and twenty patients with head and neck arteries CTA in our hospital from May 2019 to June 2023,we were randomly divided into group A and B,with 60 cases in each group,group A using bolus-tracking technique,group B using the lowdose test-bolus combined with dual-flow technique,head and neck arteries CTA was used in both groups,the image quality of the two groups was evaluated subjectively and objectively,and the dosage of contrast agent was compared between the two groups.Results Most of the images in the two groups could satisfy the diagnosis,and the larger blood vessels in the head and neck could be clearly displayed,but the borderline branches of the cerebral vessels in group B were more clearly displayed,and the pollution of cerebral veins was less in group B than that in group A,therefore,the subjective score of image quality in group B was higher than that in group A(P<0.05).There was no significant difference in the CT values of aortic arch,left common carotid artery bifurcation,left internal carotid artery siphon,left middle cerebral artery M1,left posterior cerebral artery P1 and left vertebral artery initiation between the two groups(P>0.05);There was no significant difference in the objective scores of the two groups,as well as in the image noise,signal-to-noise ratio(SNR),and contrast-to-noise ratio(CNR)of the aortic arch,left common carotid artery bifurcation,and left middle cerebral artery M1 segment(P>0.05);The dosage of contrast agent in group B was significantly lower than that in group A(P<0.05).Conclusions Comparing with conventional bolus-tracking technology,it achieves more satisfactory image quality and has less amount of contrast agents dosage in 64-row spiral CT head and neck arteries angiography using low dose test-bolus and dual flow technology,and has the promotion value.