不同部位注射对比剂对头颈部CTA图像质量的影响

摘要

目的：对比研究经不同部位注射对比剂，对头颈部血管成像质量影响，找到注射对比剂的理想部位。方法连续收集100例行头颈部CT血管成像（CTA）检查的患者，随机分为A、B两组，每组各50例。A组患者经右上肢静脉注射对比剂，B组患者经左上肢静脉注射对比剂。两组患者均采用团注跟踪触发法扫描，感兴趣区放于降主动脉内，触发阈值为120HU。CT扫描和对比剂注射参数完全一致。扫描结束后测量颈总动脉远端CT值，并由两名医师对图像质量和对比剂反流情况进行评分。结果 A组患者颈总动脉增强CT值（501±71）HU高于B组（461±104）HU（t=6.96，P<0.05），A组图像质量评分范围（3，5）分，高于B组（1，5）分（z=-0.68，P<0.01）。B组有3例患者图像质量评分≤2分，图像无法诊断。结论经患者右侧上肢注射对比剂进行头颈CTA检查，图像质量和成功率优于经左侧上肢静脉注射对比剂组。%ObjectiveTo evaluate whether the image quality of head and neck CTA was affected by the different injection position,and to find an ideal injection position.Methods100 continuous patients who underwent head and neck CTA were randomly divided into group A and B. Contrast medium was injected intravenously in the right and left upper limb respectively in group A and B. Bolus tracking-triggered technique was used in CT scan in both 2 groups,the region of interest(ROI)was placed on the descending aorta,and the triggered threshold was set as 120 HU. All scan and contrast injection parameters of the two groups were consistent. The CT value of distal common carotid artery was measured,the image quality and the reflux of the contrast medium was evaluated by two radiologists blindly and independently with 5 scale method.ResultsThe CT value of distal common carotid arteries of group A(501±71)HU was higher than group B(461±104)HU(t= 6.96,P<0.05);The image quality score of group A(3,5) was higher than group B(1,5)(z= -0.68,P<0.01). The image of 3 patients in group B did not meet the diagnostic requirement.Conclusions The image quality of patients who received the contrast medium injection in right upper limb intravenously was higher than that of patients with left upper limb intravenous injection.