标题：双源CT大螺距扫描模式在急性肺栓塞成像中的优势

      作者：张新成，徐建，耿园园，李培秀，梁建利，刘晓军    (中国石油天然气集团公司中心医院影像科，河北 廊坊 065000)

      卷次： 2018年29卷17期

      【摘要】 目的 探讨双源CT大螺距低对比剂扫描模式在急性肺栓塞(APE)检查中的应用价值及其与常规CT扫描模式相比的优势。方法 收集中国石油天然气集团公司中心医院2017年2~5月期间共136例临床高度怀疑急性肺栓塞APE并接受增强检查的患者资料，从中随机抽取15例常规肺动脉增强扫描和15例Flash大螺距低对比剂增强扫描者的资料，评价两组患者的图像质量、辐射剂量、扫描时间、对比剂剂量以及对小血管肺栓塞的诊断效果。结果 常规组和Flash组在肺动脉强化CT值上均能达到诊断要求。常规组不同的动脉区域CT值：肺动脉主干为(485.01±9.30) HU，左肺动脉为(478.93±6.59) HU，右肺动脉为(482.95±7.24) HU，而Flash组上述三个部位的CT值分别为(483.88±9.81) HU、(478.40±7.56) HU及(479.17±4.30) HU，差异均无统计学意义(P>0.05)；但常规组的扫描时间、CT剂量指数(CTDI)、剂量长度乘积(DLP)和有效剂量(ED)分别为(4.37±0.37) s、(5.55±0.29) mGy、(226.88±20.05) mGy·cm及(3.75±0.18) mSv，Flash组分别为(1.23±0.10) s、(3.74±0.18) mGy、(181.45±10.91) mGy·cm及(2.61±0.38) mSv，差异均具有统计学意义(P<0.05)。结论 Flash大螺距、低对比剂扫描技术能够在减少危重患者对比剂和辐射剂量的同时准确的诊断急性肺栓塞，提高了扫描的成功率，对临床的治疗具有重要意义。
      【关键词】 计算机成像；大螺距；对比剂；急性肺栓塞；影像技术
      【中图分类号】 R563.5 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2439—04

Advantages of high-pitch dual-source CT scan mode in imaging of acute pulmonary embolism.
ZHANGXin-cheng, XU Jian, GENG Yuan-yuan, LI Pei-xiu, LIANG Jian-li, LIU Xiao-jun. Department of Medical Imaging,Central Hospital of China National Petroleum Corporation, Langfang 065000, Hebei, CHINA
【Abstract】 Objective To investigate the application value of high-pitch dual-source CT scanning with low con-trast medium in the diagnosis of acute pulmonary embolism (PE) and its advantages over the conventional CT scanningmode. Methods Clinical data were collected from 136 patients who were suspected highly as acute pulmonary embo-lism and received enhancing examinations in the China National Petroleum Corporation Centre Hospital, from February2017 to May 2017. The data of 15 cases receiving conventional CT scanning (conventional group) and 15 cases undergo-ing Flash high-pitch dual-source CT scanning with low contrast medium (Flash Group) were collected randomly to evalu-ate the image quality, dose of radiation, scanning time, dose of contrast medium, and the diagnosis effect of small vesselpulmonary embolism. Results The pulmonary artery enhanced CT value reached the diagnostic requirements in bothconventional group and Flash group. CT value of different arterial regions (pulmonary artery trunk, left pulmonary artery,right pulmonary artery) were (485.01±9.30) HU, (478.93±6.59) HU, (482.95±7.24) HU in conventional group, versus(483.88±9.81) HU, (478.40±7.56) HU and (479.17±4.30) HU in Flash group, respectively (P>0.05). The time of scanning,CT dose index (CTDI), dose length product (DLP), and effective dose (ED) were (4.37 ± 0.37) s, (5.55 ± 0.29) mGy,(226.88±20.05) mGy·cm, and (3.75±0.18) mSv in the conventional group, respectively, as compared with (1.23±0.10) s,(3.74±0.18) mGy, (181.45±10.91) mGy·cm, and (2.61±0.38) mSv in Flash group (P<0.05). Conclusion Flash high-pitchdual-source CT scanning with low contrast medium can not only reduce the dose of contrast and radiation in critical pa-tients, but also make an accurate diagnosis of acute pulmonary embolism, which may improve the success rate of thescanning and has vital significance for clinical treatment.
      【Key words】 Computed tomography; High-pitch; Contrast medium; Acute pulmonary embolism; Imaging tech-nology·论 著·doi:10.3969/j.issn.1003-6350.2018.17.021基金项目：河北省廊坊市科技计划支撑项目(编号：2014013010C)