不同对比剂浓度对能谱CT冠脉成像的影响研究

目的 研究不同对比剂浓度对能谱CT冠脉成像所产生的影响。方法 将2016年5月~2017年6月我院收治的60例冠状动脉性心脏病患者随机分为Ⅰ组、Ⅱ组及Ⅲ组，各20例，均进行能谱CT冠脉影像检查，Ⅰ组使用的对比剂浓度为320 mgl/ml，Ⅱ组使用的对比剂浓度为350 mgl/ml，Ⅲ组使用的对比剂浓度为370 mgl/ml，比较三组患者在最佳单能量条件下的动脉管腔强化效果。结果 三组患者获取动脉管腔平均CT值均超过400 Hu，Ⅲ组升主动脉根部平均CT值比Ⅰ组及Ⅱ组稍高，Ⅰ组左主干平均CT值比Ⅱ组及Ⅲ组稍低，Ⅱ组右侧冠状动脉CT值比Ⅰ组及Ⅲ组稍高，差异均无统计学意义（P＞0.05）；Ⅱ组升主动脉根部及左主干平均信噪比比Ⅰ组及Ⅲ组略好，Ⅲ组右侧冠状动脉近端信噪比及Ⅰ组及Ⅰ组略好，差异均无统计学意义（P＞0.05）。结论 三种对比剂浓度均可用于能谱CT冠脉影像检查，比剂浓度为320 mlg/ml时完全可以满足临床对诊断的要求，同时具有较高的安全性，值得推广。

Effect of Different Concentration of Contrast Medium on Coronary Angiography with Energy Dispersive CT

Abstract:Objective To study the effects of different concentrations of contrast media on coronary angiography by energy dispersive CT.Methods From May 2016 to June 2017,60 patients with coronary heart disease were randomly divided into three groups:group I, group II and group III with 20 cases each.All patients were examined by energy dispersive CT coronary angiography,the concentration of contrast agent in group I was 320 mgl/ml,the concentration of contrast agent was 350 mg l/ml,the concentration of contrast medium used in group III was 370 mgl/ml,and the enhancement effect of arterial lumen under the best single energy condition was compared among the three groups.Results The average CT values of the three groups were more than 400 Hu.The average CT value of the ascending aorta in group III was slightly higher than that in group I and group II.The mean CT value of the left main trunk in group I was slightly lower than that in group II and group III.The CT value of the right coronary artery in group II was slightly higher than that in group I and group III,the difference was not statistically significant(P>0.05).The average signal-to-noise ratio(SNR)of ascending aortic root and left main artery in group II was slightly better than that in group I and group Ⅲ,and the signal-to-noise ratio of proximal end of right coronary artery in group III was slightly better than that in group I and group I,the difference was not statistically significant(P>0.05).Conclusion All three concentrations of contrast agents can be used for coronary angiography with spectroscopic CT.When the specific agent concentration is 320 mlg/ml,the requirements for clinical diagnosis can be fully met.At the same time,it has higher safety and is worthy of promotion.