标题：注射速率、对比剂剂量对3D-DSA脑血管造影成像效果的影响

      作者：聂少锋 1，薛萍 2    1.西安交通大学第一附属医院韩城医院神经内科，陕西 韩城 715400；2.韩城市人民医院神经内科，陕西 韩城 715400

      卷次： 2019年30卷21期

      【摘要】 目的 研究注射速率、对比剂剂量对三维数字减影血管造影(3D-DSA)成像效果的影响。方法 回顾性分析 2016年 1月至 2018年 12月在西安交通大学第一附属医院韩城医院需行 3D-DSA脑血管造影的 310例颅内血管病变患者的临床资料。根据注射速率和注射剂量分为A组(1.5 mL/s、350 mgI/mL) 77例、B组(3 mL/s、350 mg I/mL) 79例、C组(1.5 mL/s、400 mgI/mL) 78例和D组(3 mL/s、400 mgI/mL) 76例；分别计算各组患者轴位图像上颈内动脉岩段(C2)、眼段(C6)、大脑中动脉水平段(M1)、大脑前动脉水平段(A1)的信噪比(SNR)和对比噪声比(CNR)；检测各组患者术前及术后 24 h血肌酐(Scr)值；并对容积再现(VR)和最大密度投影(MIP)重建图像进行评分。结果 各组患者造影前后的Scr值比较差异无统计学意义(P>0.05)；D组患者的C2段、C6段、M1段、A1段SNR值及CNR值明显高于C组，C组明显高于B组，B组明显高于A组，差异均有统计学意义(P<0.05)；D组患者的VR图像评分及MIP图像评分[(4.89±0.38)分、(4.91±0.32)分]明显高于C组[(4.75±0.41)分、(4.53±0.34)分]，C组明显高于B组[(4.19±0.35)分、(4.00±0.39)分]，B组明显高于A组[(3.50±0.39)分、(3.48±0.34)分]，差异均有统计学意义(P<0.05)。结论 3 mL/s的注射速率和400 mgI/mL对比剂注射量可以有效提高3D-DSA脑血管造影成像效果，且在一定速率和剂量范围内不会使患者血清Scr显著升高。
      【关键词】 三维数字减影血管造影；血管造影成像；注射速率；剂量对比剂
      【中图分类号】 R816.2 【文献标识码】 A 【文章编号】 1003—6350（2019）21—2799—03

Effects of injection rate and contrast agent dose on imaging of 3D-DSA cerebral angiography.
NIE Shao-feng 1, XUEPing 2. 1. Department of Neurology, Hancheng Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Hancheng715400, Shaanxi, CHINA; 2. Department of Neurology, Hancheng People's Hospital, Hancheng 715400, Shaanxi, CHINA
【Abstract】 Objective To study the effects of different injection rates and doses of contrast agents on three-di-mensional digital subtraction angiography (3D-DSA). Methods A retrospective analysis was performed on the clinicaldata of 310 patients with intracranial vascular lesions who underwent 3D-DSA cerebral angiography in Hancheng Hospi-tal, the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to December 2018. According to injec-tion rate and injection dose, the patients were divided into group A (1.5 mL/s, 350 mgI/mL, 77 cases), group B (3 mL/s,350 mgI/mL, 79 cases), group C (1.5 mL/s, 400 mgI/mL, 78 cases) and group D (3 mL/s, 400 mgI/mL, 76 cases). Thesignal-noise ratio (SNR) and contrast-noise ratio (CNR) at petrous segment (C2) and eye segment (C6) of internal carot-id artery, at horizontal segment (M1) of middle cerebral artery, and at horizontal segment (A1) of anterior cerebral arteryin the axial images of all groups were calculated. The serum creatinine (Scr) values in all groups were measured beforeangiography and 24 h after angiography. The volume rendering (VR) and reconstructed images of maximum intensityprojection (MIP) were scored. Results There were no significant difference in Scr among all groups before and afterangiography (P>0.05); the SNR and CNR values of C2, C6, M1 and A1 segments were significantly higher in group Dthan in group C, in group C than in group B, and in group B were significantly higher than in group A (P<0.05); thescores of VR and MIP images in group D were respectively 4.89±0.38 and 4.91±0.32, which were significantly higherthan corresponding 4.75±0.41 and 4.53±0.34 in group C, followed by 4.19±0.35 and 4.00±0.39 in group B, and then3.50±0.39 and 3.48±0.34 in group A (all P<0.05). Conclusion The contrast agent with injection rate of 3 mL/s and in-jection volume of 400 mgI/mL can effectively improve imaging of 3D-DSA cerebral angiography, and it will not in-crease serum Scr of patients in a certain rate and dose range.
      【Key words】 Three-dimensional digital subtraction angiography (3D-DSA) imaging; Angiography imaging; In-jection rate; Dose contrast agent