优化对比剂注射技术在 CT 血管造影中对肾段动脉图像质量的影响

摘要

目的：探讨优化对比剂注射技术在256排螺旋 CT 血管造影（CTA）中对主肾动脉及肾段动脉图像质量的影响。方法选取行肾动脉 CTA 检查的98例体质量相近的患者，将其随机分为 A 组和 B 组，应用的对比剂为碘普罗胺（370 mg/ml）。A 组50例：根据患者体质量选择对比剂用量（1．0 ml/kg）；B 组48例：对比剂用量在 A 组用量基础上减去10 ml。以 CT 原始横断位图像为基础，结合容积再现（VR）、最大密度投影（MIP）等重建图像对两组各级肾动脉图像质量及对比剂用量进行统计学分析。结果 A 组50例患者：共显示肾动脉100条；B 组48例患者：共显示肾动脉96条。两组主肾动脉及各肾段分支显示清晰，两者比较差异无统计学意义（P ＞0．05）。两组图像质量评分分别为（4．937±0．177）分和（4．565±0．189）分，两者比较差异无统计学意义（P ＞0．05）。对比剂用量分别为（68．76±8．17）ml 和（58．27±6．48）ml，差异有统计学意义（P ＜0．05）。结论256排螺旋 CT 血管造影在肾动脉造影中，与依据患者体质量选择对比剂用量比较，在此基础上再减少10 ml 的优化对比剂注射技术亦能清晰显示肾段动脉，获得满足诊断要求的图像，从而为临床诊断肾段动脉狭窄和了解肾肿瘤分支血供提供了重要的信息。%Objective To discuss the image quality of the main renal artery and renal branch on optimization injection contrast agent in 256 slice spiral CT angiography(CTA).Methods The study enrolled 98 patients in similar body mass who took the renal artery CT angiography,and they were randomly divided into A group and B group. Ultravist solution(370 mg/ml)was used as contrast media.In A group,50 cases according to patients’body mass choose contrast agent (1.0 ml/kg),in group B,there were 48 cases:the contrast media dose was subtracted 10 ml on the basis of group A.Based on the original CT transverse image,and combined with VR,MIP reconstruction images of two groups were analyzed in renal artery image quality and contrast agent for statistical analysis.Results In A group, 100 renal arteries were shown in 50 patients,in B group,96 renal arteries were shown in 48 patients.The main renal artery and branch were clearly displayed,there were no statistical significance between them(P > 0.05).The image quality scores of the two groups were (4.937±0.177)marks and (4.565 ±0.189)marks,there were no significant difference between them(P >0.05).The dose of contrast medium was (68.76 ±8.17)ml and (58.27 ± 6.48)ml, there were statistical significance between them (P <0.05).Conclusion In the renal artery angiography with 256 slice spival CT,compared with the dose tailored to patients′ body mass injection protocol,the contrast media dose which was subtracted 10 ml on that basis injection protocol can provide satisfactory quality,and can provide important information for clinical diagnosis of renal artery stenosis and understanding the branch blood of renal tumor.