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低浓度对比剂结合双低剂量在CT肺动脉血管成像中的临床应用
Application of Low Concentration Contrast Agent Combined Double Low Dose in CT Pulmonary Angiography for Pulmonary Embolism
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摘要: 目的探讨低浓度对比剂结合双低剂量在CT肺动脉血管成像(CTPA)中的应用价值。方法连续纳入临床怀疑肺动脉栓塞行CTPA检查患者60例，随机分为2组，每组30例，其中试验组采用80 kV，碘克沙醇(320 mg／mL)15 mL；对照组采用120 kV，碘必乐(370 mg／mL)50 mL。测量肺动脉干及左、右肺动脉和各叶动脉CT值（取平均值），同时对原始数据进行最大密度投影（MIP）、曲面重建（CPR）和容积再现（VR）重建，由两名高年资放射科医师采用双盲法对图像整体质量和上腔静脉污染进行评分评价。结果所有患者均成功完成CTPA成像，且图像整体质量均满足临床诊断需求，差异无统汁学意义(P>0.05)；实验组静脉污染评分优于对照组，差异有统计学意义（P<0.01）。实验组的CT值〔（423.2±89.4） HU〕与对照组CT值〔（465.7±85.6） HU〕差异无统计学意义（P>0.05）。实验组肺动脉信噪比（SNR）、对比噪声比（CNR）均低于对照组，差异有统计学意义（P均<0.01）。实验组辐射剂量容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）和体型特异性剂量估量值（SSDE）均比对照组低，差异有统计学意义（P均<0.01）。结论低浓度对比剂结合双低剂量CTPA成像可获得满足临床诊断的图像，减轻了静脉污染，降低了碘对比剂用量及患者的辐射剂量，具有良好的临床应用价值。Abstract: Objective To investigate the feasibility of low concentration contrast agent combined double low dose in CT pulmonary angiography. Methods60 patients with clinically suspected pulmonary embolism examed by CT pulmonary angiography (CTPA) were divided into two groups (experimental group: n=30, 80 kV, 15 mL, 320 mg I/mL;control group: n=30, 120 kV, 50 mL, 370 mg I/mL). The average CT value of main right and left pulmonary arteries, lobar arteries was calculated. Imaging post processing techniques included curved plannar reconstruction (CPR), volume rendering (VR) and maximal intensity projection (MIP). The artifact of the remaining contract in the superior vena cava and overall quality of the image were observed and analyzed by two senior doctors who were double blinded. ResultsAll patients in two groups completed CTPA successfully. The image qualities of two groupssatisfy clinical diagnostic requirements and no difference of the image qualities was observed between two groups (P>0.05). The evaluation of venous pollution in experimental group was better than that of control group (P<0.01).No difference of CT values were observed between two groups 〔experimental group (423.2±89.4) HU, control group (465.7±85.6) HU〕(P>0.05). The SNR and CNR in experimental group were lower than those in control group (P<0.01 both).The CT dose index volume (CTDIvol)， dose-length product (DLP) and size-specific dose estimates (SSDE) in experimental group were significantly lower than those incontrol group (P<0.01 all). ConclusionThe low concentration contrast agent combined double low dose in CT pulmonary angiography satisfies clinical diagnostic requirements. It has good clinical value for it could reduce venous pollution, iodine contrast agent and radiation exposure.
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期刊类型引用(10)
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4. 沙金叶，刘文源，邹明宇. 基于双低CT扫描技术的儿童复杂先天性心脏病混合现实建模的可行性. 中国医科大学学报. 2022(10): 884-888 . 百度学术
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6. 梁卡丽，戴贵东. 双源CT头颈部联合动脉成像时的CTA参数优化方法及效果分析. 中西医结合心血管病电子杂志. 2020(03): 3+23 . 百度学术
7. 周婷，王刚. 64排螺旋CT双低剂量技术应用于肺动脉CTA的价值. 现代医院. 2020(04): 622-624 . 百度学术
8. 席伟. 双低对比剂在头颈部双源CTA血管成像中的应用. 中西医结合心血管病电子杂志. 2019(04): 86-87 . 百度学术
9. 李胜华，欧宁锋，马海锋，梁宇峰，陈欣健. 低管电压联合低对比剂量CT扫描在肺动脉成像中的应用价值. 海南医学. 2019(24): 3227-3230 . 百度学术
10. 李磊，赵飞，夏春潮，刘露，李真林. 低剂量对比剂联合生理盐水在第二代双源CT头颈部CT血管成像中的临床应用. 华西医学. 2018(08): 1015-1018 . 百度学术
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