改良64层CT颅颈联合动脉成像技术的临床价值

目的探讨改良64层CT颅颈联合动脉成像技术对改善颅颈部动脉血管显示能力的临床价值。方法选择临床拟诊缺血性脑血管病患者60例行颅颈CT血管成像（CTA）检查,随机分为两组,A组（常规组）：pitch0.8,转速0.75s/r,80ml对比剂;B组（优化组）：pitch1.1,转速0.5s/r,35ml对比剂＋35ml生理盐水。由两名主治以上资历的影像医师采用双盲评分法及客观测量在工作站对所形成的图像质量进行评价。结果 （1）两名诊断医师关于评价注射侧头臂静脉对比剂伪影、颈部动脉与大脑中动脉M2段成像质量以及颅内静脉显影情况,均具有较好一致性（Kappa值分别为0.824、0.887、0.831、0.785）。（2）注射侧头臂静脉对比剂伪影评分,A、B两组间差异具有统计学意义（P〈0.05）;（3）B组颈总动脉起始部、椎动脉起始部及大脑中动脉M2的成像质量明显优于A组,差异有统计学意义（P〈0.05）。（4）客观测量B组颈动脉分叉部、椎动脉及大脑中动脉M2的CT值略低于A组,但CT值均大于200HU,且图像质量满足诊断需要。结论改良64层CT颅颈联合动脉成像技术能显著改善动脉血管图像质量,对提高颈总动脉起始段、椎动脉起始段及颅内动脉病变的显示能力具有重要价值。

Cinical value of modified 64-slice CT angiography technique in brain and neck combined artery imaging

Objective To explore the clinical value of modified 64-slice CT angiography technique in brain and neck combined artery imaging.Methods Sixty patients underwent brain and neck CTA examination and were randomly divided into two groups：A（compared group）,pitch 0.8,rotation speed 0.75 s/r,and 80 ml contrast;B（modified group）,pitch 1.1,rotation speed 0.5 s/r and 35 ml contrast following 35 ml saline.Two senior radiologists evaluated and analyzed the image quality in the workstation with double blinded scoring method.Results （1） According to the two radiologist’ s opion,the injected venous artifact,the imaging qulality of carotid artery and the middle cerebral artery M2 segment,and the imaging of intracal veins have good consistency（kappa value was 0.824,0.887,0.831,0.785 respectively）.（2） Statistics of the injected vein artifact,there is statistical significance（P 〈0.05） between A and B group.（3） Group B is better than Group A （P 〈 0.05） in the imaging quality of the proximal carotid artery,the proximal vertebral artery and the M2 segment of middle cerebral artery.（4） CT value：Group B is a bit lower than Group A at the carotid bifurcation,the vertebral artery and the M2 segment of middle cerebral artery,but both values are above 200 HU and meet the diagnostic need.Conclusions The modified 64-slice CT angiography technique can improve the imaging quality significantly and has an important clinical value in improving the imaging of the proximal carotid artery,the proximal vertebral artery and intracranial arteries.