碘对比剂每秒注入量对64排螺旋CT冠脉成像质量的影响

 目的 探讨碘对比剂每秒注入量对心脏冠脉成像质量的影响。方法 选取2019-09至2020-01解放军总医院第一医学中心做冠脉CTA检查的患者60例,按对比剂每秒注入量不同(4.0 ml/s、5.0 ml/s),分为研究组和对照组,每组30例,由两位高年资医师测量主动脉根部和右冠主干、左前降支、回旋支血管的CT值,采用五分法对图像进行评分,并统计CT值300～450 Hu的比例。结果 对照组主动脉根部和右冠主干、左前降支、回旋支血管CT值均高于研究组,差异有统计学意义(P＜0.05)。研究组主动脉根部和右冠主干、左前降支、回旋支的CT值均介于300~450 Hu(100.0%),而对照组分别为63.3%、66.7%、83.3%及93.3%;研究组与对照组的冠脉图像主观评价得分,差异无统计学意义。结论 对比剂每秒注入量对冠脉CTA图像质量及CT值有影响,4 ml/s每秒注入量时血管CT值略低,但对影像诊断无影响。

Effect of iodine contrast media flow rate on coronary artery imaging quality of 64-slice spiral CT

Objective To investigate the effect of the iodine contrast agent at different flow rates on the quality of coronary imaging. Methods A total of 60 patients undergoing coronary CTA examination at the First Medical Center of PLA General Hospital between September 2019 and January 2020 were randomly divided into the experimental group and control group according to the flow rate (4.0 ml/s, 5.0 ml/s), with 30 cases in each. The CT values of the aortic root, right coronary artery, left anterior descending artery, and circumflex artery were measured by two senior physicians, while the images were scored using the five-point method. The percentage of CT values that ranged from 300 to 450 Hu was calculated. Results CT values of the aortic root, right coronary artery, left anterior descending artery and circumflex artery in the control group were higher than those in the experimental group, and the difference was statistically significant (P<0.05). These values all ranged from 300 to 450 HU in the experimental group (100.0%), compared with 63.3%, 66.7%, 83.3% and 93.3% respectively in the control group. There was no significant difference in subjective evaluation scores of coronary artery image between the two groups. Conclusions The flow rate of the contrast agent can influence the image quality and CT value of coronary CTA. The blood vessel CT value is slightly lower at the flow rate of 4 ml/s, but has no effect on image diagnosis.