标题：对比剂不同团注方式对下肢动脉CT血管造影成像质量的影响

      作者：林观生 1，马周鹏 1，付文兵 1，柳峰 2    金山区中西医结合医院放射科 1、心内科 2，上海 201501

      卷次： 2019年30卷7期

      【摘要】 目的 探讨对比剂不同注射方式对下肢动脉CT血管造影(CTA)成像质量的影响。方法 将2016年5月至2018年9月金山区中西医结合医院下肢动脉CTA检查的91例患者按照随机数表法分为A、B、C三组，其中A、C组各30例，B组31例。A、B两组均用单筒高压注射器注射100 mL对比剂，流率分别为3.5 mL/s、4.5 mL/s；C组用双筒高压注射器以4.5 mL/s流率先注射60 mL对比剂，然后以相同流率注射40 mL生理盐水，其余扫描条件均相同。比较三组患者的图像质量及碘摄入量。结果 A组患者的图像优良率、合格率分别为56.7%、66.7%，均低于B组的87.1%、93.5%及C组的86.7%、93.3%，差异均有统计学意义(P<0.05)，而B组和C组患者的图像优良率及合格率比较差异均无统计学意义(P>0.05)；A组患者图像髂总动脉分叉水平、股骨干1/2水平处股动脉、胫骨1/2水平处胫前动脉及足背动脉水平4个层面的动脉CT值分别为(250.33±25.27) Hu、(251.70±14.64) Hu、(198.63±13.74) Hu及(181.96±10.73) Hu，B组的分别为(314.26±19.73) Hu、(324.31±20.56) Hu、(241.62±12.48) Hu及(203.46±11.58) Hu，C组的分别为(323.47±25.76) Hu、(325.95±18.65) Hu、(249.62±17.62) Hu及(210.32±9.92) Hu；三组患者图像同层面动脉CT值比较，A组均低于B组及C组，差异均有统计学意义(P<0.05)，而B组和C组患者比较差异无统计学意义(P>0.05)；C组每例患者的碘摄入量为 22.2 g，而A组和B组每例均为 37 g，C组较A组及B组均减少了 40%碘摄入。结论 采用双筒高压注射器以较高流率团注低剂量对比剂并联合生理盐水行下肢动脉CTA可获得高质量图像，减少对比剂用量。
      【关键词】 对比剂；注射方式；下肢动脉；血管造影术；X线计算机；体层摄影术
      【中图分类号】 R543 【文献标识码】 A 【文章编号】 1003—6350（2019）07—0878—04

Effect of contrast agent on the quality of CT angiography of lower extremity artery with different bolus injectionmethods.
LIN Guan-sheng 1, MA Zhou-peng 1, FU Wen-bing 1, LIU Feng 2. Department of Radiology 1, Department ofCardiovascular Medicine 2, Shanghai Jinshan TCM-Integrated Hospital, Shanghai 201501, CHINA
【Abstract】 Objective To investigate the effect of contrast agent on the quality of CT angiography (CTA) oflower extremity artery with different injection methods. Methods A total of 91 patients who underwent CTA examina-tion of lower extremity arteries in Shanghai Jinshan TCM-Integrated Hospital during May 2016 and September 2018were randomly divided into 3 groups according to the random number table method, including A, B and C groups, with30 cases in group A and C, respectively, and 31 cases in group B. Both group A and B were injected with 100 mL of con-trast agent using a single cylinder high pressure syringe at a flow rate of 3.5 mL/s and 4.5 mL/s, respectively. Group Cwas injected with 60 mL of contrast agent at a flow rate of 4.5 mL/s with double cylinder high pressure syringe, and theninjected with 40 mL of normal saline at the same flow rate; and the remaining scan parameters were the same. The imagequality and iodine intakes were compared in three groups. Results The excellent and qualified rate of image in group Awere respectively 56.7% and 66.7%, which were lower than corresponding 87.1% and 93.5% in group B, 86.7% and93.3% in group C; all differences were statistically significant (P<0.05). There was no statistically significant differencein the image excellent rate and qualified rate between group B and group C (P>0.05). In group A, the image CT valueswere measured in 4 different levels, including common iliac arteries branches (250.33±25.27) Hu, femoral artery at 1/2level of the femur shaft (251.70±14.64) Hu, anterior tibial artery at the front 1/2 of the tibia (198.63±13.74) Hu, and dor-salis pedis (181.96±10.73) Hu. Those in group B were respectively (314.26±19.73) Hu, (324.31±20.56) Hu, (241.62±12.48) Hu, and (203.46±11.58) Hu, and in group C were (323.47±25.76) Hu, (325.95±18.65) Hu, 249.62±17.62) Hu,(210.32±9.92) Hu, respectively; all differences were statistically significant (P<0.05). The artery CT values in the samelevel were compared between the three groups of patients, and the A group was lower than the B and C groups (P<0.05);but there was no significant difference in the comparison between patients in group B and group C (P>0.05). The iodineintake of each patient in group C was 22.2 g, while that in group A and group B was 37 g. The C group had a 40% reduc-tion in iodine intake compared with group A and group B. Conclusion High quality images can be obtained by using adouble cylinder high pressure syringe with bolus injection of low-dose contrast agent combined with normal saline at ahigh flow rate for lower extremity artery CTA, reducing the dosage of contrast agent.
      【Key words】 Contrast agent; Injective method; Lower extremity artery; Angiogr