不同对比剂及注射速度对64排螺旋CT冠状动脉成像的影响

摘要

目的 比较在64 排螺旋CT 冠状动脉造影时,不同浓度对比剂以不同速度注射时对血管增强效果及图像质量的影响.方法 将接受64排螺旋CT 冠状动脉检查的患者,选取体质量指数(BMI)为20.20～25.80 kg/m2的患者60 例,分为A、B、C 组,每组20 例.A 组:使用350 mgI/ml 浓度的欧乃派克,注射流率为4.5 ml/s(碘流量1 575 mgI/s); B 组:应用浓度为370 mgI/ml 的优维显,团注流率为4.3 ml/s(碘流量1 591 mgI/s);C 组:使用350 mgI/ml 浓度的欧乃派克,注射速度为4.3 ml/s(碘流量1 505 mgI/s).分别对A 组与C 组、A 组与B 组、B 组与C 组的升主动脉、降主动脉、左主干及左前降支、左回旋支、右主干近段的强化程度及图像质量进行比较.结果 3 组患者左回旋支的增强平均值均较本组其它血管的强化数值偏小.除左回旋支外,A 组其余血管增强平均值均大于C 组.B 组各段血管的强化平均值均大于相应的A 组及C 组;除B 组与C 组患者升主动脉及降主动脉的增强程度存在显著性差异外,A 组与C 组、A 组与B 组、B 组与C 组的其它各段血管的增强程度没有显著性差异.C 组4支血管图像质量评分平均值大于A 组和B 组;A 组与B 组图像质量评分没有显著性差异,A 组和C 组、B 组与C 组4 支血管间质量评分均存在显著性差异;350 mgI/ml 浓度对比剂可获得更佳增强效果图像.结论 64排螺旋CT 冠状动脉成像对比剂浓度及注射速度的优化具有可行性,并能获得更佳的增强图像.%Objective To investigate the effect of different contrast media with different injection speeds on the enhanced effect of coronary angiography by 64—detector row helical CT. Methods Sixty consecutive patients with the BMI of 20.20~25.80 kg/m2 undergoing coronary angiography by 64—slice CT were divided into three groups. Group A was injected contrast medium of 350 mgI/ml with the speed of 4.5 ml/s and group C was 4.3 ml/s, group B was injected contrast medium of 370 mgI/ml with the speed of 4.3 ml/s. The enhanced effect and picture quality of three groups in ascending aorta, descending aorta, the trunk and branch of coronary artery were compared. Results The enhanced values of LCX were smaller than those of the other vessels in the same group. Except LCX, the enhanced values in other vessels of group A exceeded those of group C. The enhanced values of group B exceeded those of group A and C; except in aorta of group B and C, the difference of enhancement in other vessels between group A and C, group A and B, group B and C was not significant. Except left circumflex, the enhanced values of group C were less than those of group A. The average score of picture quality in group C surpassed that in group A and B. The score between group A and B existed significant difference, but there was no significant difference between group A and C, group B and C. The contrast medium of 350 mgI/ml could obtain the optimal enhanced image. Conclusion The optimum concentration of contrast medium in coronary angiography by 64—detector row helical CT is feasible and more excellent enhanced image can be gained.