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目的:比较腹主动脉联合下肢动脉CT成像中两种不同对比剂注射方案对对比剂剂量的影响。方法:搜集临床上怀疑腹主-下肢动脉疾病行CT血管成像(CTA)的患者50例,随机分为A、B组,对比剂(350 mg I/m L),A组:男16例,女9例,平均年龄(58.53±9.39)岁,平均体质量(67.86±11.65)kg,平均扫描范围(124.65±8.28)cm。B组:男17例,女8例,平均年龄(60.87±9.76)岁,平均体质量(66.23±12.42)kg,平均扫描范围(122.59±9.12)cm。A组注射流率4 m L/s,对比剂用量1.5 m L/kg。B组第1期5 m L/s注射20 m L,第2期3 m L/s注射剩余量;B组对比剂总量=1.5 m L/kg×体重-4 m L/s×(B方案对比剂注射时间-A方案对比剂注射时间)。对比剂注射完毕两组均以3 m L/s流率无缝隙注射生理盐水30 m L。两组均选择智能触发技术,监测平面为腹主动脉(右膈肌水平),阈值≥150 HU。对两组5个动脉段图像质量进行评分;测量5个动脉段CT值,记录两组对比剂剂量。均进行独立样本t检验。结果:A组5个动脉段图像质量评分、平均CT值分别为:4.76±0.44、(328.46±21.45)HU(腹主动脉段),4.20±0.58和(330.96±22.52)HU(髂动脉段),4.36±0.57、(327.16±23.65)HU(股动脉-腘动脉段),3.32±0.63、(296.53±20.43)HU(小腿动脉段),3.12±0.53、(257.26±21.21)HU(足背或足底动脉段);B组分别为:4.72±0.46、(329.75±23.12)HU(腹主动脉段),4.08±0.57、(331.63±24.64)HU(髂动脉段),4.16±0.55、(319.89±21.79)HU(股动脉-腘动脉段),3.24±0.66、(290.44±21.57)HU(小腿动脉段),3.28±0.46、(243.76±27.29)HU(足背或足底动脉段);B组均低于A组,差异均无统计学意义(P>0.05)。A、B组对比剂剂量分别为(93.79±13.68)m L和(74.61±14.76)m L,差异有统计学意义(P<0.05)。结论:对比剂流率5 m L/s+3 m L/s分期注射可在不影响图像质量的前提下降低腹主动脉联合下肢动脉CTA的对比剂用量。
OBJECTIVE: To compare the effects of two contrast media injections on contrast medium dose in abdominal aorta and lower extremity arterial CT imaging. Methods: Fifty patients with clinically suspected abdominal aorto-arterial disease underwent CT angiography (CTA) were randomly divided into A and B groups and contrast agent (350 mg I / m L). Group A: 16 males, The average age was (58.53 ± 9.39) years, the average body weight was (67.86 ± 11.65) kg, the average scanning range was (124.65 ± 8.28) cm. Group B: 17 males and 8 females, mean age (60.87 ± 9.76) years, average body weight (66.23 ± 12.42) kg, mean scan range (122.59 ± 9.12) cm. Group A injection rate of 4 m L / s, contrast agent dosage of 1.5 m L / kg. Group B, the first phase of 5 m L / s injection of 20 m L, the second period of 3 m L / s injection of the remaining amount; Group B total amount of contrast agent = 1.5 m L / kg × body weight -4 m L / s × Protocol contrast agent injection time-A protocol contrast agent injection time). After injection of contrast agent, normal saline (30 m L) was injected into the two groups at a flow rate of 3 m L / s. The two groups were selected smart trigger technology, the monitoring plane as the abdominal aorta (right diaphragm muscle level), the threshold ≥ 150 HU. The image quality of two groups of 5 arteries was scored. The CT values of the 5 arteries were measured and the dosages of contrast medium were recorded. Independent samples t test. Results: The image quality scores of 5 arteries in group A were 4.76 ± 0.44 (328.46 ± 21.45) HU (abdominal aorta), 4.20 ± 0.58 (330.96 ± 22.52) HU (iliac arteries) , 4.36 ± 0.57, (327.16 ± 23.65) HU (femoral artery - popliteal artery segment), 3.32 ± 0.63, (296.53 ± 20.43) HU (leg artery segment), 3.12 ± 0.53, (257.26 ± 21.21) HU The diameter of the artery in the group B was 4.72 ± 0.46 (329.75 ± 23.12) HU (abdominal aorta), 4.08 ± 0.57 (331.63 ± 24.64) HU (iliac artery), 4.16 ± 0.55 (319.89) ± 21.79) HU (femoral artery-popliteal artery segment), 3.24 ± 0.66 (290.44 ± 21.57) HU (lower leg artery segment), 3.28 ± 0.46 (243.76 ± 27.29) HU Group A were lower than those in group A, with no significant difference (P> 0.05). The doses of contrast medium in group A and group B were (93.79 ± 13.68) m L and (74.61 ± 14.76) m L, respectively, with statistical significance (P <0.05). Conclusion: Contrast agent flow rate of 5 m L / s + 3 m L / s staged injection can reduce the amount of contrast agent in CTA of abdominal aorta and lower extremity artery without affecting image quality.