Kirchner J, Kickuth R, Laufer U, Noack M, Liermann D
Klinik für Radiologische Diagnostik und Nuklearmedizin, Katholisches Marienhospital Herne, Universitätsklinik der Ruhr- Universität Bochum, Germany.
Clin Radiol. 2000 May;55(5):368-73. doi: 10.1053/crad.2000.0376.
Ultrafast detector technology enables bolus-triggered application of contrast media. In a prospective study we investigated the benefit of this new method with the intention of optimizing enhancement during examination of the chest and abdomen.
In total, we examined 548 patients under standardized conditions. All examinations were performed on a Somatom Plus 4 Power CT system (Siemens Corp., Forchheim, Germany) using the CARE-Bolus software. This produces repetitive low-dose test images (e.g. for the lung: 140 kV, 43 mA, TI 0.5 s) and measures the Hounsfield attenuation in a pre-selected region of interest. After exceeding a defined threshold, a diagnostic spiral CT examination was begun automatically. The data obtained from 321 abdominal CT and 179 lung CT examinations were correlated with different parameters such as age, weight and height of the patients and parameters of vascular access. In a group of 80 patients, the injection of contrast medium was stopped after reaching a pre-defined threshold of an increase of 100 HU over the baseline. Then, we assessed the maximal enhancement of liver, pulmonal artery trunk and aortic arch.
There was no correlation between bolus geometry and age, body surface or weight. In helical CT of the abdomen the threshold was reached after a mean trigger time of 27 s (range 13-67 s) and only 65 ml (range 41-105 ml) of contrast medium were administered. In helical CT of the lung the threshold was reached after 21 s (range 12-48 s) and the mean amount of administered contrast medium was 48 ml (range 38-71 ml).
Bolus triggering allows optimized enhancement of the organs and reduces the dose of contrast material required compared with standard administration.
超快探测器技术可实现团注触发式造影剂应用。在一项前瞻性研究中，我们调查了这种新方法的益处，旨在优化胸部和腹部检查期间的强化效果。
我们总共在标准化条件下检查了548例患者。所有检查均在Somatom Plus 4 Power CT系统（德国福希海姆西门子公司）上使用CARE-Bolus软件进行。该软件会生成重复性低剂量测试图像（例如用于肺部：140 kV，43 mA，TI 0.5 s），并在预先选定的感兴趣区域测量亨氏衰减值。在超过定义的阈值后，自动开始进行诊断性螺旋CT检查。从321例腹部CT和179例肺部CT检查中获得的数据与患者的年龄、体重和身高以及血管通路参数等不同参数相关。在一组80例患者中，在达到比基线增加100 HU的预先定义阈值后停止注射造影剂。然后，我们评估了肝脏、肺动脉主干和主动脉弓的最大强化程度。
团注形态与年龄、体表面积或体重之间无相关性。在腹部螺旋CT中，平均触发时间为27秒（范围13 - 67秒）后达到阈值，仅注入65毫升（范围41 - 105毫升）造影剂。在肺部螺旋CT中，21秒（范围12 - 48秒）后达到阈值，注入造影剂的平均量为48毫升（范围38 - 71毫升）。
与标准给药相比，团注触发可实现器官的优化强化，并减少所需造影剂的剂量。
