Itoh Shigeki, Ikeda Mitsuru, Achiwa Masataka, Ota Toyohiro, Satake Hiroko, Ishigaki Takeo
Department of Technical Radiology, Nagoya University School of Health Sciences, 461-8673 Daikou-minami 1-1-20, Higashi-ku, Nagoya, Japan.
Eur Radiol. 2003 May;13(5):1085-94. doi: 10.1007/s00330-002-1607-8. Epub 2002 Sep 18.
Our objective was to assess the effects of the injection rate of contrast material and of a 5% dextrose flush on enhancement in multiphase hepatic CT using a multislice CT scanner. Most patients had chronic hepatitis and/or liver cirrhosis. One hundred eighty examinations, in which two sequential acquisitions were performed during a single breath-hold followed by third- and fourth-pass acquisitions, were randomized into four protocols: contrast injection at 0.1 ml/kg body weight s(-1) over 21 s without and with a 30-ml flush in groups 1 and 2, respectively, and contrast injection at 0.07 ml/kg body weight s(-1) over 30 s without and with a flush in groups 3 and 4, respectively. Contrast enhancement in each acquisition was measured in the aorta, portal vein, and liver. The visualization of hepatic arterial branches was scored by visual assessment. The highest aortic enhancement was observed in the first-pass acquisition in all groups. At the higher injection rate (groups 1 and 2), aortic enhancement in the first-pass acquisition was significantly more intense, whereas portal venous and hepatic enhancement was significantly less intense. The use of a flush considerably improved aortic enhancement at the beginning of the second-pass acquisition. In the visual assessment of hepatic arterial branches, the protocols with the higher injection rate received significantly higher grades. Multislice CT permits the entire liver to be imaged during an almost exclusively arterial phase by shortening the injection duration for a given volume of contrast material.
我们的目的是使用多层螺旋CT扫描仪评估造影剂注射速率和5%葡萄糖冲洗对肝脏多期CT增强的影响。大多数患者患有慢性肝炎和/或肝硬化。180次检查（在一次屏气期间进行两次连续采集，随后进行第三次和第四次采集）被随机分为四个方案：第1组和第2组分别以0.1 ml/kg体重·s⁻¹的速率在21秒内注射造影剂，第1组不进行冲洗，第2组进行30 ml的冲洗；第3组和第4组分别以0.07 ml/kg体重·s⁻¹的速率在30秒内注射造影剂，第3组不进行冲洗，第4组进行冲洗。在每次采集时测量主动脉、门静脉和肝脏的造影剂增强情况。通过视觉评估对肝动脉分支的显影进行评分。所有组在首次采集中均观察到最高的主动脉增强。在较高注射速率组（第1组和第2组），首次采集中的主动脉增强明显更强，而门静脉和肝脏增强明显更弱。冲洗的使用在第二次采集开始时显著改善了主动脉增强。在对肝动脉分支的视觉评估中，较高注射速率的方案获得了显著更高的评分。多层螺旋CT通过缩短给定体积造影剂的注射持续时间，几乎可以在完全动脉期对整个肝脏进行成像。
