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目的：探讨纵隔血管螺旋ＣＴ扫描的最佳延迟时间及造影剂之含碘浓度。材料与方法：本文搜集１２０例胸部螺旋ＣＴ增强扫描资料，４０例为回顾性研究组，主要研究强化血管出现伪影时的ＣＴ值，例如上腔静脉区等。另８０例为前瞻性研究组，其中又分Ｓｍａｒｔｐｒｅｐ组（研究最佳延迟时间）及造影剂浓度组（确定纵隔血管增强之最合适的造影剂浓度）。图像质量的评判标准为血管强化充分又无伪影存在。结果：头臂静脉、上腔静脉、升主动脉和肺动脉强化符合标准又无其周围伪影时其ＣＴ值分别在１９０～５３０ＨＵ，１１７～３６６ＨＵ，１１２～２５７ＨＵ及１２８～２５０ＨＵ。伪影的出现与造影剂碘浓度及延时时间密切相关，在经稀释的４种浓度中，优维显２１４ｍｇＩ／ｍｌ及２３０ｍｇＩ／ｍｌ增强效果佳而无伪影。ＧＥ螺旋ＣＴＳｍａｒｔｐｒｅｐ技术研究延迟时间表明，２０例中５例阈值达２００～３００ＨＵ，延时为４０～４５秒时，纵隔血管强化满意且无伪影。结论：本文前瞻组，纵隔血管强化好又无放射状伪影，合理的技术方案为Ｕｌｔｒａｖ－ｉｓｔ３００ｍｇＩ／ｍｌ，注射速率２ｍｌ／秒，总量８０ｍｌ，延时４５秒，或常规应用Ｓｍａｒｔｐｒｅｐ技术。我们认为降低造影剂碘浓度到２１３ｍｇＩ?
Objective: To explore the best delay time of mediastinal spiral CT scanning and contrast agent iodine concentration. Materials and Methods: We collected 120 cases of thoracic spiral CT enhanced scanning data, 40 cases of retrospective study group, the main research to strengthen the vascular artifacts CT value, such as the superior vena cava region. The other 80 cases were prospective study groups, which were divided into Smartprep group (study the best delay time) and contrast medium concentration group (the most suitable concentration of contrast medium for determining mediastinal vascular enhancement). Image quality assessment criteria for the full and no artifacts of blood vessels exist. Results: The CT values of the superior brachiocephalic vein, the superior vena cava, the ascending aorta and the pulmonary artery in compliance with standard without peripheral artifact were 190 ~ 530HU, 117 ~ 366HU, 112 ~ 257HU and 128 ~ 250HU, respectively. The emergence of artifacts and contrast agent iodine concentration and delay time are closely related to the four concentrations diluted, excellent Victoria significant 214mgI / ml and 230mgI / ml enhancement effect without artifacts. The latency study of the GE spiral CTSmartprep technique showed that in 20 of 5 patients with a threshold of 200-300 HU and a delay of 40-45 s, mediastinal vascular enhancement was satisfactory and artifact-free. CONCLUSIONS: In this prospective group, mediastinal vessels were enhanced with good radiographic artifacts. A reasonable protocol was Ultrav-ist 300 mgI / ml, injection rate 2 ml / sec, total volume 80 ml, delay 45 seconds, or routinely using the Smartprep technique. We think reducing the contrast agent iodine concentration to 213mgI?