BodyTom移动CT的辐射剂量和图像质量评估

目的 通过对新一代全身移动CT（BodyTom CT）与常用固定CT机的比较,对其辐射剂量和图像质量评估。方法 用CATPHAN 500性能测试体模评价图像质量,用常规的100 mm笔形电离室、CT聚甲基丙烯酸甲酯（PMMA）体部体模及头部体模测量辐射剂量（头模直径为160 mm,体部体模直径为320 mm,它们宽度均为140 mm）。结果 BodyTom CT的空间分辨率、密度分辨率与两类固定CT接近,差异无统计学意义（P>0.05）。对比度噪声比（CNR）降低20%左右：头部扫描模式下,明显低于飞利浦64排CT和东芝320排CT（重建函数soft时,t=-4.82、-6.98,P<0.05;重建函数standard时t=-20.60、-20.09,P<0.05）;体部扫描模式下,也明显低于飞利浦64排CT和东芝320排CT（重建函数soft时,t=-5.67、-12.82,P<0.05;重建函数standard时,t=-3.39、-9.18,P<0.05;重建函数sharp时,t=-3.88、-3.21,P<0.05）。BodyTom CT的辐射剂量高于固定CT,相同参数下体部体模比飞利浦64排CT机剂量高22.97%（t=9.48,P<0.05）,比东芝320排CT机高29.60%（t=11.66,P<0.05）;头模比飞利浦64排CT机高29.76%（t=23.44,P<0.05）,比东芝320排CT机高33.22%（t=23.11,P<0.05）。结论 移动CT的图像与常规CT图像质量相当时,辐射剂量增高20%以上。     

State of the art trends in imaging renal of colic

Radiology has a primary role in the work-up of renal colic, both to confirm urolithiasis and to help determine management. The traditional imaging has been conventional radiography and intravenous urogram with multidetector non-contrast-enhanced helical computed tomography (NCECT) now the modality of choice. Nuclear medicine studies for renal colic are done now infrequently at most institutions. Ultrasound (US) is often done, especially in the emergency department, and magnetic resonance imaging (MRI) is promising. Radiation dose reduction is now on everyone’s minds: Lower-dose CT techniques are being tested and used, and US and MR are considered as first modalities of choice in pregnant women and children.     

Present-day imaging of patients with renal colic

In the past decade alternatives to urography have been proposed for the study of patients with renal colic. In 1992 it was suggested to replace urography with KUB and ultrasonography. In 1993 the combination of KUB and ultrasonography followed by urography in unresolved cases was proposed and, in 1995, it was suggested to replace urography with unenhanced helical CT (UHCT). This article illustrates the contribution of UHCT to the study of patients with renal colic and analyses advantages and shortcomings of the technique compared with other diagnostic approaches. Diagnostics of the patient with renal colic is based on the detection of direct and indirect signs which allow identification of not only the calculus, with a sensitivity of 94–100 % and accuracy of 93–98 % according different authors, but also other signs that can serve to guide patient management and evaluate long-term prognosis. Unenhanced helical CT has the capability to detect extraurinary abnormalities which present with flank pain and mimic renal colic. The examination technique affects the quality of the images and therefore diagnostic accuracy as well as the dose to the patient. With regard to setting parameters, the choice of thickness and table feed should be guided by numerous factors. Multiplanar reconstruction is indicated in the study of the entire ureter course to identify the exact site of the calcification for the urologist to perform an evaluation similar to that obtained by urography. Many authors consider UHCT to be a valuable tool for suggesting the best therapeutic approach. Among these there are also urologists. The evaluation is based on the stone detection, its size and level in the urinary tract. Cost analysis shows that the cost of UHCT is equal to or inferior to the cost of urography. With regard to the dose, different data are reported in the literature. A high pitch (more than 1.5) and a thin collimation (3-mm thickness) are good compromise between quality and dose which can be compared to the dose of normal urography. What is to be done if helical CT is not available? If helical CT is not available, plain film plus ultrasonography should be considered. This approach does not solve all the cases; in unresolved cases urography is indicated. It should also be noted that US has a good sensitivity in detecting other conditions such as biliary lithiasis, acute pancreatitis, acute appendicitis and abdomino-pelvic masses which are responsible for pain that mimics renal colic. In conclusion, IVU should not have any more the priority in investigating the patients with renal colic. Helical CT should be the first choice in imaging a patient with renal colic. If this technique is not available, plain film and ultrasonography should be considered adding urography in unresolved cases.     

Combined magnetic resonance urography and targeted helical CT in patients with renal colic: a new approach to reduce delivered dose

PURPOSE: To determine whether magnetic resonance urography (MRU), obtained before helical computed tomography (CT) in patients with acute renal colic, can help delimit the obstructed area to be subsequently examined by a targeted CT scan, thus reducing the dose of radiation. MATERIALS AND METHODS: Patients (51) with symptoms of acute renal colic underwent MRU and a total urinary tract helical CT. CT images from the 5 cm below the level of ureteral obstruction as demonstrated by MRU were selected out. Combined interpretation of MRU and selected CT images constituted protocol A. Protocol B consisted of the entire unenhanced helical CT of the urinary tract. The two protocols were compared regarding the following points: 1) sensitivity in diagnosing the presence of obstructing urinary stones, and 2) the delivered radiation dose. RESULTS: Protocol A and protocol B had, respectively, 98% and 100% sensitivity in demonstrating ureteral stone as a cause of renal colic. Estimated average dose calculated from phantom study was 0.52 mSv for protocol A and 2.83 mSv for protocol B. Therefore, the effective radiation dose was 5.4 times lower in protocol A compared to protocol B. CONCLUSION: Combined MRU and short helical CT has a high sensitivity in detecting ureteral calculi with a reduced radiation dose.     

Low-dose CT of the paranasal sinuses with eye lens protection: effect on image quality and radiation dose

The purpose of the study was to assess the effect of lens protection on image quality and radiation dose to the eye lenses in CT of the paranasal sinuses. In 127 patients referred to rule out sinusitis, an axial spiral CT with a lens protection placed on the patients eyes was obtained (1.5/2/1, 50 mAs, 120 kV). Coronal views were reconstructed at 5-mm interval. To quantify a subjective impression of image quality, three regions of interest within the eyeball were plotted along a line perpendicular to the protection at 2, 5, and 9 mm beneath skin level on the axial images. Additionally, dose reduction of a bismuth-containing latex shield was measured using a film-dosimetry technique. The average eyeball density was 17.97 HU (SD 3.7 HU). The relative increase in CT density was 180.6 (17.7), 103.3 (11.7), and 53.6 HU (9.2), respectively. There was no diagnostic information loss on axial and coronal views observed. Artifacts were practically invisible on images viewed in a bone window/level setting. The use of the shield reduced skin radiation from 7.5 to 4.5 mGy. The utilization of a radioprotection to the eye lenses in paranasal CT is a suitable and effective means of reducing skin radiation by 40%.     

CT KUB scans for renal colic: Optimisation of scan range to reduce patient radiation burden

IntroductionNon-contrast CT KUB scans performed to assess renal colic should be limited to scanning between the upper pole of the highest kidney and the pubic symphysis to minimise unnecessary irradiation. This audit aimed to assess the amount of overscanning in CT KUBs outside this range.MethodsCT KUB scans taken over a 10-day period were assessed. Unnecessary overscan above the highest kidney was measured as a percentage of the total scan range. A target of less than 10% overscanning was set. The vertebral position of the upper pole of the highest kidney was also measured and compared to the actual level of the scan.Results88 patients were assessed. 89.8% (79/88) of scans didn't meet the target of less than 10% overscanning above the highest kidney, and were associated with a higher radiation dose to the patient. The average overscanning above the highest pole of the kidney was 16.4% of the whole scan. The average overscan below the pubic symphysis was 1.54%. We also found that 100% of scanned kidneys lied below the upper border of the T11 vertebra, in spite of scans starting as high as T7.ConclusionA large proportion of scans included unnecessary overscanning above the highest kidney. We have identified the upper border of the T11 vertebral body as a potential location from which to begin the upper margin of a CT KUB scan.Implications for practiceBy starting CT KUB scans at the upper border of the T11 vertebral body, we can allow the whole kidney to be imaged while minimising unnecessary overscanning above the kidney, thus lowering excess patient irradiation while still producing high quality scans.     

Dual-source 128-slice MDCT neck: Radiation dose and image quality estimation of three different protocols

Purpose

To estimate the radiation dose and image quality of single-source (SSCT), high-pitch (HPCT), and dual-energy (DECT) protocols of a dual-source CT (DSCT) system for the examination of neck.

Materials and methods

180 patients were randomized to one of the three protocols: 60 patients (age: 55.4 ± 12 years; range: 44–84 years) were examined with a SSCT, other 60 (59.5 ± 16.4years; R: 40–85) with HPCT, and the last 60 (61.1 ± 14.9 years; R: 47–84) were examined with a DECT protocol. All examinations were performed using a DSCT system. The used protocols: Group-1 (SSCT: 120 kV; effective mAs: 185.4 ± 17.7), Group-2 (HPCT: 120 kV; eff. mAs: 97.7 ± 11.8), and Group-3 (DECT: 80 kV/140 kV with tin-filter; eff. mAs: 248.5 ± 25.7; 187 ± 21.2). A 100 ml iomeprol non-ionic contrast material was injected in to the patients during examination.

Results

Insignificant results were yielded regarding SNR and CNR between the groups (group-1 vs. 2: 0.3125, group-1 vs. 0.6W: 0.6875, group-2 vs. 0.6W: 0.3125), except DECT-80 (group-1 vs. 80 kV: 0.04289, group-2 vs. 80 kV: 0.025, group-0.6W vs.80 kV: 0.04567) and 140 kV data, moreover, qualitative analysis yielded the same results. Mean effective-dose was significantly lower (p < 0.05) in group-2 (1.06 ± 0.16 mSv) compared to group-1 (2.05 ± 0.22 mSv) or group-3 (1.76 ± 0.2 mSv). Single- and dual-energy comparison showed a significant difference (group-1 vs. 3: p = 0.00001 and group-2 vs. 3: p = 0.00001) for CTDIvol (percent difference: 16%, 64%) or DLP (PD: 15.5%, 50.5%).

Conclusion

Quantitative and qualitative analysis showed similar results for SSCT, HPCT, and DECT-0.6W datasets regarding quality. HPCT yielded lower dose compared to other groups, however, the DECT achieved a lower and significant dose difference from the SSCT protocol. HPCT and DECT can be used with similar image quality and lower radiation dose compared to SSCT for the scans and can be utilized to various clinical advantages.     

不同摄影源像距对小儿胸部数字X线技术辐射剂量图像质量的影响

目的不同摄影源像距对小儿胸部数字X线技术(DR)辐射剂量、图像质量的影响。方法选取我院2017至2018年收治的60例行胸部X线(DR)检查的患儿为研究对象开展回顾性分析,首先进行体模预实验曝光,采用同一管电压和不同摄影源像距(SID)(80~150 cm),其中10 cm为1组,记录每次曝光的毫安秒和入射体表剂量(ESD)。选取体模预实验中ESD相对低剂量和剂量适中的2组(90 cm和110 cm)开展临床试验。所有患儿住院期间采用同一X线机对同一患儿进行胸部DR的初查和复查,并分为初查组和复查组,初查组采用SID=110 cm,复查组采用SID=90 cm,由3位影像学专家采用5分法对图像质量进行打分。结果通过影像学专家评判,80~150 cm的DR曝光图像质量无差异,且不同的SID下实施胸部体模DR,得到的毫安秒与辐射剂量不相同,同一体模在相同曝光指数下,随着SID的增大,毫安秒与辐射剂量均逐渐增大;初查组的图像质量评分为(4.9±1.0)分,复查组的图像质量评分为(4.9±1.0),2组的图像质量评分比较差异无统计学意义(P>0.05)。结论患儿DR胸部摄影中不同SID,其体表辐射剂量具有明显差异,SID为90 cm时能够大幅度地降低X线管的输出剂量,减少体表辐射剂量,延长X线管的使用寿命。     

A PC program for estimating organ dose and effective dose values in computed tomography

Dose values in CT are specified by the manufacturers for all CT systems and operating conditions in phantoms. It is not trivial, however, to derive dose values in patients from this information. Therefore, we have developed a PC-based program which calculates organ dose and effective dose values for arbitrary scan parameters and anatomical ranges. Values for primary radiation are derived from measurements or manufacturer specifications; values for scattered radiation are derived from Monte Carlo calculations tabulated for standard anthropomorphic phantoms. Based on these values, organ doses can be computed by the program for arbitrary scan protocols in conventional and in spiral CT. Effective dose values are also provided, both with ICRP 26 and ICRP 60 tissue-weighting coefficients. Results for several standard CT protocols are presented in tabular form in this paper. In addition, potential for dose reduction is demonstrated, for example, in spiral CT and in quantitative CT. Providing realistic patient dose estimates for arbitrary CT protocols is relevant both for the physician and the patient, and it is particularly useful for educational and training purposes. The program, called WinDose, is now in use at the Erlangen University hospitals (Germany) as an information tool for radiologists and patients. Further extensions are planned. Received: 9 March 1998; Revision received: 4 June 1998; Accepted: 4 November 1998     

不同方向的肺部螺旋CT扫描图像质量的对比分析

目的：对比分析两种不同方向的肺部螺旋CT扫描的图像质量。方法：随机选择100例肺部扫描的患者,者人头→足和足→头两种方向扫描，两组图像按有无呼吸运动伪影，对比剂伪影来评定质量。结果：两组图像质量存在明显的差异。结论：肺部螺旋CT扫描时，采用由足→头方向扫描，能够获得更好的满足诊断要求的CT图像。     

Acute flank pain: comparison of unenhanced helical CT and ultrasonography in detecting causes other than ureterolithiasis

Several conditions can clinically mimic renal colic. We assessed the accuracy of non-contrast-enhanced helical CT and of ultrasonography (US) in offering an alternative explanation for flank pain. In a 3-year period, 181 patients with acute flank pain underwent US and non-contrast-enhanced helical CT in a blinded sequence. Their efficacy in detecting both alternative causes of pain and additional findings unrelated to the pain was assessed in 160 cases with a confirmed diagnosis. An alternative cause was found in 23 cases (14%). US gave 4 false-negative results (1 acute appendicitis, 1 ovarian cyst torsion, 1 diverticulitis, and 1 papillary necrosis) and 2 false-positive results (1 acute pyelonephritis and 1 diverticulitis), with a 78% sensitivity and a 98% specificity for nonlithiasic causes. CT gave 5 false-negative results (1 complicated ovarian cyst, 1 pleuritis, 1 epididymitis, 1 acute pyelonephritis, and 1 papillary necrosis) and 1 false-positive (1 simple ovarian cyst described as a complicated lesion), resulting in a 74% sensitivity and a 99% specificity for diagnosing alternative causes. There were 130 additional US findings in 68 patients and 151 additional CT findings in 77 patients. A wide spectrum of findings can be identified in subjects imaged for flank pain. Non-contrast-enhanced helical CT and US have comparable accuracy in diagnosing causes other than stone disease. Electronic Publication     

颞骨CT扫描方案对晶体剂量影响的研究

目的 探讨颞骨CT的不同扫描方式对眼晶体剂量的影响。方法 在相同管电压和有效mAs下,对成人离体头颅标本分别行横断位和冠状位的标准单层连续扫描、常规多层螺旋扫描以及改良的多层螺旋扫描。分析各种扫描方式的CT容积剂量指数(CTDI_vol)和剂量长度乘积(DLP),计算被检体有效剂量,并使用热释光剂量片测量晶体的器官剂量。结果 单层连续扫描时总体有效剂量为1.21 mSv,横断位扫描的晶体剂量为50.96 mGy,冠状位晶体剂量为1.73 mGy;常规多层螺旋扫描的有效剂量为0.803 mSv,晶体剂量为40.17 mGy;改良的多层螺旋扫描的有效剂量为0.803 mSv,晶体剂量为10.33 mGy。结论 相同管电压和有效mAs下,单层连续横断位和冠状位扫描的总体有效剂量和晶体剂量分别是常规螺旋扫描的1.51和1.31倍。改良的多层螺旋CT扫描方式可将螺旋扫描时的晶体剂量降低74.3%,可作为临床颞骨CT扫描的选择方式。     

Split-bolus CT-urography using dual-energy CT: Feasibility, image quality and dose reduction

Purpose

To prospectively evaluate the feasibility of dual-energy (DE) split-bolus CT-urography (CTU) and the quality of virtual non-enhanced images (VNEI) and DE combined nephrographic-excretory phase images (CNEPI), and to estimate radiation dose reduction if true non-enhanced images (TNEI) could be omitted.

Patients and methods

Between August and September 2011, 30 consecutive patients with confirmed or suspected urothelial cancer or with hematuria underwent DE CT. Single-energy TNEI and DE CNEPI were obtained. VNEI was reconstructed from CNEPI. Image quality of CNEPI and VNEI was evaluated using a 5-point scale. The attenuation of urine in the bladder on TNEI and VNEI was measured. The CT dose index volume (CTDI (vol)) of the two scans was recorded.

Results

The mean image quality score of CNEPI and VNEI was 4.7 and 3.3, respectively. The mean differences in urine attenuation between VNEI and TNEI were 14 ± 15 [SD] and −16 ± 29 in the anterior and posterior parts of the bladder, respectively. The mean CTDI (vol) for TNEI and CNEPI was 11.8 and 10.9 mGy, respectively. Omission of TNEI could reduce the total radiation dose by 52%.

Conclusion

DE split-bolus CTU is technically feasible and can reduce radiation exposure; however, an additional TNEI scan is necessary when the VNEI quality is poor or quantitative evaluation of urine attenuation is required.     

A rational approach to dose reduction in CT: individualized scan protocols

The aim of this study was to demonstrate that dose reduction and constant image quality can be achieved by adjusting X-ray dose to patient size. To establish the relation between patient size, image quality and dose we scanned 19 patients with reduced dose. Image noise was measured. Four radiologists scored image quality subjectively, whereby a higher score meant less image quality. A reference patient diameter was determined for which the dose was just sufficient. Then 22 patients were scanned with the X-ray dose adjusted to their size. Again, image noise was measured and subjective image quality was scored. The dose reduction compared with the standard protocol was calculated. In the first group the measured noise was correlated to the patient diameter (rho=0.78). This correlation is lost in the second group (rho=-0.13). The correlation between patient diameter and subjective image quality scores changes from rho=0.60 (group 1) to rho=-0.69 (group 2). Compared with the standard protocol, the dose was reduced (mean 28%, range 0-76%) in 19 of 22 patients (86%). Dose reduction and constant noise can be achieved when the X-ray dose is adjusted to the patient diameter. With constant image noise the subjective image quality increases with larger patients.     

Radiation dose to the lens in sequential and spiral CT of the facial bones and sinuses

A tendency for over-utilization of the radiological examinations of facial bones and sinuses has been observed. The radiosensitive lens is exposed to radiation during such examination. Comparison of routine roentgenography and spiral axial and coronal CT in sequential and spiral acquisition modes with different mAs values was undertaken using Alderson Rando Phantom. The spiral-CT technique with pitch 1.5 performed in the coronal plane gave the lowest radiation dose to the lens as compared with other CT methods and only seven times higher than routine sinus roentgenography. Received: 27 March 2000 Revised: 13 July 2000 Accepted: 13 July 2000     

双源CT肺动脉成像不同扫描模式图像质量及辐射剂量的对比研究

目的 探讨双源CT肺动脉成像双能量扫描与普通扫描(单能量扫描)对图像质量及辐射剂量的影响.方法 临床怀疑肺栓塞并行炫速双源CT肺动脉成像单、双能量扫描患者各61例,按扫描方式不同分为A、B2组,A组为双能量扫描(80/Sn140 kV),B组为普通扫描(Care kV选择输出管电压).对2组图像进行图像质量评分及测量2组肺动脉CT值、空气标准差(背景噪声)并计算信噪比(SNR),同时对2组图像的辐射剂量进行对比分析,以P＜0.05为具有统计学意义.结果 2组图像质量主观评分2名观察者间一致性较好,Kappa分别为0.705、0.827,2组图像质量评分差异无统计学意义(P＞0.05);A组右下肺动脉CT值高于B组,差异有统计学意义(P＜0.05),其余肺动脉的CT值差异均无统计学意义(P＞0.05);A组图像噪声稍高于B组,SNR稍低于B组,差异无统计学意义(P＞0.05);A、B2组CT剂量指数(CTDIvol)、剂量长度乘积(DLP)有效剂量(ED)分别为(6.13± 1.09)mGy和(12.41±3.42) mGy、(172.49士41.35)mGy· cm和(332.16±115.65) mGy.cm、(2.41±0.58) mSv和(4.65±1.62) mSv,差异具有统计学意义(P=0.000),A组CTDIvol、DLP、ED较B组分别减少50.60％、48.07％、48.17％.结论 双源CT肺动脉成像双能量扫描(80/Sn140 kV)的图像质量与单能量扫描相近,X线辐射剂量较单能量扫描明显降低.     

CT在肾创伤诊断与分类中的价值

目的评价CT在肾损伤的诊断和分类中的价值。方法回顾性分析76例肾损伤的CT表现。结果76例中单纯性肾挫伤9例，单纯性肾内血肿7例，肾挫裂伤24例，单纯性肾包膜下血肿10例，肾撕裂伤21例，肾撕裂伴血肿及尿外渗2例，单纯性肾周血肿3例，合并腹内脏器伤41例，下位肋骨骨折18例。同时，所有患者的肾损伤是依据CT表现分为4大类型。结论螺旋CT能明确诊断肾损伤，并确定损伤类型，为临床制定治疗方案提供重要依据。     

Low-dose dental computed tomography: significant dose reduction without loss of image quality

Purpose: To measure and reduce the patient dose during computed tomography (CT) for dental applications. Material and Methods: Lithium fluoride thermoluminescent dosimeters were implanted in a tissue-equivalent humanoid phantom (Alderson-Rando-Phantom) to determine doses to the thyroid gland, the active bone marrow, the salivary glands, and the eye lens. Dental CT was performed with spiral CT and a dental software package. The usual dental CT technique was compared with a new dose-reduced protocol, which delivered best image quality at lowest possible radiation dose, as tested in a preceding study. Image quality was analysed using a human anatomic head preparation. In addition, the radiation dose was compared with panoramic radiography and digital volume tomography (DVT). Eight radiologists evaluated all images in a blinded fashion. A Wilcoxon rank pair test was used for statistical evaluation. Results: Radiation dose could be reduced by a factor of 9 (max.) with the new dose-reduced protocol (e.g. bone marrow dose from 23.6 mSv to 2.9 mSv; eye lens from 0.5 mSv to 0.3 mSv; thyroid gland from 2.5 mSv to 0.5 mSv; parotid glands from 2.3 mSv to 0.4 mSv). Dose reduction did not reduce image quality or diagnostic information. Conclusion: A considerable dose reduction without loss of diagnostic information is achievable in dental CT. As radiation exposure of the presented low-dose protocol is expected to be in the same range as DVT, low-dose dental CT might be superior to DVT, because CT can be used to evaluate soft tissues as well.     

螺距的选择对胸腹主动脉夹层320层CT成像质量的影响

目的：探讨螺距的选择对320层CT螺旋扫描模式胸腹主动脉夹层图像质量及辐射剂量的影响。方法：连续纳入可疑急性主动脉综合征患者100例,分为两组,A组（50例）采用螺距为53、B组（50例）采用螺距为95进行胸腹主动脉CTA扫描。使用Toshiba Aquilion one 320 CT机,120 kV,450 mA,0.35 s/r。选用体部前置滤线器和后置过滤器,重建层厚0.5 mm。应用SPSS 11.5软件分别对A组和B组的CT有效辐射剂量、图像噪声均值进行非配对t检验。结果：A组平均有效辐射剂量为18.19 mSv,B组为9.52 mSv,较A组有效辐射剂量平均减少50%。A组患者平均扫描时间为9.5 s,B组为4.53 s,较A组扫描时间平均减少5.07 s。A组患者的对比剂总量平均为83.6 ml,B组为71.8 ml,较A组对比剂总量平均减少12 ml。结论：在进行胸腹主动脉CTA检查中管电压和管电流恒定不变的情况下选择大螺距扫描,可以减少扫描时间、对比剂量并显著降低辐射剂量,在保证图像质量的同时,主动脉根部搏动伪影减小,可显示冠状动脉开口及近段,从而达到优化图像的同时降低辐射剂量的目的。     

螺旋CT血管造影及血管仿真内镜技术对肾动脉狭窄的诊断与评价

目的：探讨螺旋CT血管造影（SCTA）及血管仿真内镜技术（CTVE）在肾动脉狭窄（RAS）诊断中临床应用价值。方法：7例RAS及1例RAS肾切主后患者行肾动脉SCTA及三维重建，三维重建方法包括：表面遮盖成像（SSD）和最大密度投影（MIP）。3例同时行肾动脉血管CTVE成像。结果：SCTA2DCT图像显示7例RAS患侧肾体积明显缩小，肾皮质明显变薄，无或部分强化。7例RASSSD和MIP均可清晰显示肾动脉主干狭窄的部位、狭窄程度与范围，但不能显示肾段较小肾动脉的狭窄情况。1例RAS肾切除术后MIP和SSD未见肾动脉有其分支显示。3例肾血管CTVE能显示狭窄的肾动脉开口及管腔明显变窄。结论：SCTA及CTVE是诊断肾动脉主干狭窄的有效方法，基本上可代替动脉血管造影。