不同碘浓度对比剂在肾脏MSCT增强扫描中的作用对比

目的:探讨300mgI/ml对比剂与400mgI/ml对比剂对肾脏MSCT多期增强扫描的强化作用。方法:将40例疑肾脏病变的患者随机分成两组,每组20例,分别行肾脏平扫及给予碘必乐300(300mg I/ml)与碘迈伦400(400mg I/ml)的多期增强MSCT扫描。在对比剂开始注射后18s、30s、80s、3~5min扫描。测量各期增强扫描腹主动脉、双肾动脉、双肾静脉、双肾皮质、双肾髓质、双肾盂、肾脏病变的CT强化值。观察上述结构的强化情况。结果:使用400mgI/ml对比剂组在18s与30s采集,所检测的血管与肾各结构强化均值与300mgI/ml对比剂组相比,差异有显著性意义(P<0.01),80s采集,肾动脉、肾静脉、肾髓质强化均值与300mgI/ml对比剂组相比,差异有显著性意义(P<0.01),3~5min采集,肾静脉与肾盂强化均值与300mgI/ml对比剂组相比,差异有显著性意义(P<0.01)。结论:高碘浓度对比剂对肾血管的显示优于标准碘浓度对比剂,并可降低对比剂用量。肾脏MSCT高碘浓度对比剂增强扫描在对比剂开始注射后30s与延时3~5min采集较合理。

Effect of Different Iodine Concentration of Contrast Media in the Enhancement of kidney with Multislice CT

Objective:To study the effect of contrast enhancement of kidney with contrast media containing iodine for 300 or 400mg I/ml in MSCT.Methods:Totally 40 patients with suspected kidney diseases were randomly assigned into two groups,20 patients for each group.Group A received contrast media containing 300mg iodine/ml(1.5ml/kg of body weight),whereas group B received the same agent yet containing 400mg iodine/ml(1ml/kg of body weight),the injection rate was 3ml/s.MSCT was undertaken at 18s,30s,80s and 3~5min after starting of injection.The CT value(HU) of abdominal aorta,renal arteries,veins,cortex,medulla and renal pelvis of bilateral kidney as well as renal lesion were measured to observe the degree of enhancement in different phases.Results:For group B,at 18s and 30s,high iodine concentration contrast led to greater enhancement in blood vessels and normal renal structures than group A,with significant statistical difference(P<0.01).At 80s,high iodine concentration used in group B led to greater enhancement in renal arteries,renal veins,renal medulla than group A,with significant statistical difference(P<0.01).At 3 to 5min,enhancement was greater in renal veins and renal pelvis,with significant statistical difference as well(P<0.01).Conclusion:High iodine concentration contrast media improves contrast enhancement of renal vessels,the overall volume of contrast media used could be reduced.For MSCT of kidney,it is reasonable to use high iodine concentration contrast media,and to perform the CT scanning at 30s and 3min to 5min after starting of injection.