64层螺旋CT冠脉CTA对比剂注射方案优化

目的 比较相同碘负荷情况下,不同对比剂注射方案以及相同碘浓度情况下,不同对比剂注射流率在64层螺旋CT冠脉CTA的应用效果.方法 58例可疑冠心病病例分为3组,分别采用不同对比剂注射方案进行冠脉CTA检查;对血管强化程度、重建血管清晰度进行评价.结果 300 mgI/ml×5 ml/s和370 mgI/ml×4 ml/s两种注射方案冠脉平均强化水平相似,约350～370 HU,两者差异不具有统计学意义.370 mgl/ml×4 ml/s和370 mgI/ml×3 ml/s两种注射方案在升主动脉,左、右冠状动脉主干平均强化程度分别为360 HU左右和330 HU左右,但两组间的差异不具有统计学意义,两组重建血管清晰度无统计学差异,96.3%的重建血管能够满足诊断.结论 应用370 mgI/ml×3 ml/s注射方案相当的单位时间碘负荷量,平均强化程度330 HU,能够满足64层螺旋CT冠脉CTA检查.

The optimization of contrast media injection protocol in heart coronary CTA by 64-MSCT

Objective To compare the enhancement of coronary arteries and the quality of reconstruction images using different contrast materials (CM) injection protocols on 64-multidetector computed tomography (64-MSCT) coronary angiography. Methods Fifty-eight patients were divided into three groups and underwent coronary artery CTA with three different injection protocols, respectively: group 1: 300 mgI/m×5 ml/s, 60-80 ml CM+50 ml saline, group 2: 370 mgI/ml×4 ml/s, 65-75 ml CM, group 3: 370 mgI/ml×3 ml/s, 65-75 ml CM. The enhancement of coronary arteries and the definition of the reconstructed vessels were evaluated, respectively. Results The mean degree of enhancement of coronary arteries were similar (about 350-370 HU) in group 1 and group 2. The difference between the two groups was insignificant. The mean degree of enhancement of coronary arteries in group 2 (about 360 HU) was higher than that in group 3 (about 330 HU). However, there was no significant difference between them. The quality of reconstruction images between group 2 and group 3 were equal, too. 96.3% of images were adequate for diagnostic need. Conclusion The enhancement of coronary arteries is similar using different CM injection protocols with the same time-iodine loading dose of 370 mgI/ml×3 ml/s. The enhancement of 330 HU is competent for diagnosing coronary artery disease.