摘要
目的探讨宽体能谱CT扫描结合高浓度碘对比剂(含碘400 mg/ml)肝脏静脉系统CT血管成像对布加综合征(BCS)患者的诊断价值。方法前瞻性收集2019年3月至8月郑州大学第一附属医院临床疑诊为BCS行肝脏静脉系统CT血管成像的48例患者,采用数字表法随机分为对照组和实验组,每组均24例。患者均行常规腹部CT平扫及能谱CT增强扫描。对照组对比剂采用碘海醇(含碘350 mg/ml),剂量1.6 ml/kg,流率4.0 ml/s;实验组对比剂采用碘美普尔(含碘400 mg/ml),剂量1.4 ml/kg,双流率法注射。对图像质量、辐射剂量、对比剂用量进行评价,并采用独立样本t检验、Wilcoxon秩和检验、χ2检验、Mann-Whitney U检验进行比较。结果对照组对比剂用量为(106.40±20.19)ml,高于实验组[(94.53±16.02)ml],差异有统计学意义(t=2.257,P<0.05);实验组对比剂注射流率为3.15 ml/s,对照组平均流率为4.00 ml/s,高于实验组;两组间的剂量容积指数、剂量长度乘积及有效剂量值差异均无统计学意义(P均>0.05)。实验组和对照组患者的门静脉、肝静脉、下腔静脉、肝实质的CT值及图像背景噪声、信噪比、对比噪声比差异均无统计学意义(P均>0.05)。实验组和对照组患者图像质量评分中位数均为4分,差异无统计学意义(Z=-0.124,P=0.902),图像质量可满足诊断需要。结论BCS患者采用低对比剂用量、低注射流率的方法注射高浓度碘对比剂(400 mg/ml)行肝脏静脉系统CT血管成像能谱扫描,可以获得较高质量的图像,满足诊断需求。
Objective To investigate the diagnostic value of energy spectrum CT combined with high concentration iodine contrast agent(400 mg/ml)for hepatic venous system CT angiography in patients with Budd-Chiari syndrome(BCS).Methods A total of 48 patients with BCS who underwent the hepatic venous system CT angiography were prospectively collected from March to August 2019 at the First Affiliated Hospital of Zhengzhou University.Patients were randomly divided into control group(350 mg/ml)and study group(400 mg/ml).In the control group,the dosage of iodine contrast agent was 1.6 ml/kg,and the flow rate was 4.0 ml/s.In the study group,the dosage of iodine contrast agent was 1.4 ml/kg.Double-flow rate injection protocol was used in the study group,i.e.3.50 ml/s(80%dosage),1.75 ml/s(20%dosage),3.50 ml/s(40 ml normal saline).Revolution CT scanner was used for energy spectrum scanning.Quantitative parameters,qualitative visual parameters and radiation dose were compared between the two groups.Wilcoxon test,t test,χ2 test and Mann-Whitney U test were used.Results The dosage of iodine contrast agent in the study group[(94.53±16.02)ml]was lower than that in the control group[(106.40±20.19)ml,t=2.257,P<0.05].The injection speed of the control group was higher than that of the study group(4.00 ml/s and 3.15 ml/s).CT values of portal vein,hepatic vein,inferior vena cava,and hepatic parenchyma,signal to noise ratio,contrast noise ratio,CT dose index,dose length product,effective dose and subjective scores showed no significant differences between the 2 groups(all P>0.05).Conclusion For patients with BCS,high quality images could be obtained to meet the requirement of diagnosis in hepatic vein system CT angiography using high concentration iodine contrast agent(400 mg/ml)with low dosage of contrast agent and low flow rate.
作者
李培杰
苏蕾
郭和合
高剑波
张永高
Li Peijie;Su Lei;Guo Hehe;Gao Jianbo;Zhang Yonggao(Department of Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2020年第5期408-412,共5页
Chinese Journal of Radiology
