标题：个体化双流注射法在64排螺旋CT肺动脉成像中的应用

      作者：郭强，文正青，孔伟，陈文坚，叶薇，宋惠茜，熊伟坚    韶关市第一人民医院医学影像科，广东 韶关 512000

      卷次： 2021年32卷15期

      【摘要】 目的 探究个体化双流注射法在64排螺旋CT肺动脉成像(CTPA)中的应用价值。方法 选择2019年7月至2020年10月在韶关市第一人民医院医学影像科行CTPA检查的44例疑似肺动脉栓塞(PE)患者纳入研究，按照时间先后顺序连续入组，其中A组22例采用基于体质量的个体化双时相注射法，B组22例采用基于体质量的个体化双流注射法。计算两组患者肺动脉各段的CT值，比较两组患者图像的噪声标准差图像噪声(SD)、图像信噪比(SNR)、对比噪声比(CNR)，同时比较两组患者的CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效辐射剂量(ED)、对比剂用量。结果 两组患者的肺动脉主干、双侧肺动脉、双侧上叶肺动脉、双侧下叶肺动脉、双侧下叶后基底段肺动脉和双侧下叶后基底段亚段肺动脉的CT值比较差异均无统计学意义(P>0.05)；两组患者图像的主观评分、SD、SNR、CNR比较差异均无统计学意义(P>0.05)；B组患者的CTDIvol、DLP、ED及对比剂用量分别为(4.74±0.31) mGy、(63.3±10.10) mGy·cm、(0.88±0.23) mSv/(mGy·cm)、(18.27±2.25) mL，明显低于A组的(7.74±0.91) mGy、(155.9±23.10) mGy·cm、(2.18±0.59) mSv/(mGy·cm)、(30.45±3.75) mL，差异均有统计学意义(P<0.05)。结论 基于患者体质量的个体化双流注射法在不影响诊断的前提下，能显著降低肺动脉CTPA检查的辐射剂量和对比剂用量。
      【关键词】 肺动脉栓塞；个体化双流注射法；螺旋CT；肺动脉血管成像；剂量；碘对比剂；辐射
      【中图分类号】 R445.2 【文献标识码】 A 【文章编号】 1003—6350（2021）15—1994—04

Quality analysis of individualized dual flow injection based on patient weight in 64-slice spiral CT pulmonaryangiography.
GUO Qiang, WEN Zheng-qing, KONG Wei, CHEN Wen-jian, YE Wei, SONG Hui-xi, XIONG Wei-jian.Department of Medical Imaging, Shaoguan First People's Hospital, Shaoguan 512000, Guangdong, CHINA
【Abstract】 Objective To research the quality analysis of dual flow individualized contrast agent injectionbased on patient weight in 64-slice spiral CT pulmonary angiography (CTPA). Methods Forty-four patients with sus-pected pulmonary embolism (PE) who underwent CTPA examination in Department of Medical Imaging, Shaoguan FirstPeople's Hospital from July 2019 to October 2020 were enrolled in the study. They were divided into group A and groupB according to the admission time. The patients in group A were injected with individualized dual phase injection basedon body weight. The patients in group B were given individualized dual flow injection based on body weight during pul-monary artery CT angiography. After the inspection was completed, the CT values of pulmonary artery segments in thetwo groups were compared, the image noise standard deviation (SD), image signal-to-noise ratio (SNR), and contrast tonoise ratio (CNR) of the two groups were compared, and the CT volume dose index (CTDIvol), dose length product(DLP), and effective radiation dose (ED) of the two groups were compared. Results The CT values of main pulmonaryartery, bilateral pulmonary artery, bilateral superior pulmonary artery, bilateral inferior pulmonary artery, bilateral posteri-or basal segment pulmonary artery and bilateral posterior basal segment pulmonary artery showed no significant differ-ences between group A and group B (P>0.05). The scores of SD, SNR, CNR, and image quality also showed no signifi-cant differences between the two groups (P>0.05). The CTDIvol, DLP, ED, and contrast agent dosage in group B were(4.74±0.31) mGy, (63.3±10.1) mGy·cm, (0.88±0.23) mSv/(mGy·cm）, (18.27±2.25) mL, which were significantly low-er than (7.74±0.91) mGy, (155.9±23.1) mGy·cm, (2.18±0.59) mSv/(mGy·cm), (30.45±3.75) mL in group A (P<0.05).Conclusion The application effect of individualized dual flow injection based on patient weight in pulmonary arteryCT angiography is good. It can significantly reduce radiation dose and contrast agent dosage without affecting the quali-ty of CT image.
      【Key words】 Pulmonary embolism; Individualized double flow injection; Spiral CT; Pulmonary angiography;Dosage; Iodine contrast agent; Radiation