摘要
目的探讨多层螺旋CT肺动脉造影（CTPA）使用低对比剂量的可行性。方法前瞻性连续选择2012年3月至2013年2月疑似肺动脉栓塞的患者58例行CTPA检查。按检查奇偶周数分为低对比剂量组（I组）和高对比剂量组（Ⅱ组）。I组28例：64排多层螺旋CT扫描，使用对比剂量为35ml，选择监测点上腔静脉；1I组30例：64排多层螺旋CT扫描，使用常规对比剂量80～90ml，选择监测点为肺动脉干。两组肺动脉造影图像分别测量肺动脉主干、亚段级肺动脉、肺静脉、升主动脉的CT值。计算出肺动脉的对比度噪声比（CNR）进行客观影像评价。由两名资深影像学医师以5分制对两组的CTPA图像质量进行评分。使用独立样本t检验与Mann－WhitneyU检验分析两组之间图像客观评价以及图像主观评分的统计学意义。结果I组图像的肺动脉主干CT值、亚段级肺动脉CT值、CNR均高于Ⅱ组，经独立样本t检验，均有统计学意义（t＝2．0、P=0．04；t=2．6、P：0．01；t=2．6、P：0．00）；I组图像的主动脉CT值与肺静脉CT值低于Ⅱ组，差异均有统计学意义（t=一7．9、P=0．00；t=-3．2、P=0．01）。I组图像的CNR高出Ⅱ组图像10．6％。两名资深影像诊断医师以5分法进行图像质量评估，经Mann-WhitneyU检验，医师A、医师B对I、Ⅱ两组图像质量评估均有显著统计学意义（Z=-2．3、P=0．02；Z=-2．8、P=0．02）。两名医师对两组图像质量评估的一致性经Kappa检验一致性较好（Kappa值=0．81）。结论CTPA使用35ml对比剂结合上腔静脉为监测点追踪触发扫描方法是完全可行的，并且图像质量好于常规扫描方法。
Objective To evaluate the feasibility of low contrast dose in muhislice spiral CT pulmonary angiography （CTPA）. Methods 58 patients suspected with pulmonary embolism underwent multi slice spiral CT pulmonary angiogra- phy from March 2012 to February 2013 were collected in the study. The patients were divided into two groups： group I （28 patients） underwent （CTPA） using low contrast dose of 35 ml, monitoring point was selected at superior vena cava; group Ⅱ （30 patients） undwewent CTPA using conventional contrast dose of 80 - 90 ml, monitoring point was selected at pulmo- nary trunk. The CT attenuation value of pulmonary trunk, sub segment of pulmonary artery, pulmonary vein, ascending a- orta were measured in 2 groups respectively. Contrast to noise ratio was calculated. Two experienced imaging physicians compared the image quality between 2 groups using 5 point seal. Results The CT attenuation values of pulmonary trunk, sub segment of pulmonary artery in group I were higher than that in group Ⅱ, there was statistically significant difference（ t = 2. 0 ,P = 0. 04 ; t = 2. 6 ,P = 0. 01 ; t = 2. 6 ,P = 0.00 ） between two groups. The CT attenuation values of aorta and pulmo- nary vein in group I were lower than that in group Ⅱ, there was statistically significant difference between two groups （ t = - 7.9 ,P = 0. 0 ;t = - 3.2 ,P = 0.01 ）. The images CNR of group I was higher than that of group Ⅱ. Two physicians had good consistency in evaluating image quality using Kappa test assessment （ Kappa = 0.81 ）. Conclusion CTPA using low contrast agent combined with the superior vena eava for the monitoring point is entirely feasible, and the image quality is better than conventional scanning methods.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第2期289-292,共4页
Journal of Clinical Radiology
