Goshima Satoshi, Kanematsu Masayuki, Nishibori Hironori, Kondo Hiroshi, Tsuge Yusuke, Yokoyama Ryujiro, Miyoshi Toshiharu, Onozuka Minoru, Shiratori Yoshimune, Moriyama Noriyuki, Bae Kyongtae T
Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193, Japan.
Eur J Radiol. 2007 Sep;63(3):420-6. doi: 10.1016/j.ejrad.2007.02.005. Epub 2007 Mar 23.
To determine optimal scan delays for renal arterial-, corticomedullary-, and nephrographic-phase imaging with multi-detector row computed tomography (MDCT) of the kidney using a bolus-tracking technique.
One hundred and twenty-eight patients underwent three-phase CT scan of the kidney with eight-row MDCT after receiving 2 mL/kg of 300 mgI/mL contrast medium at 4 mL/s. Patients were prospectively randomized into three groups with different scan delays for the three scan phases (arterial, corticomedullary, and nephrographic) after bolus-tracking triggered at 50 HU of aortic contrast enhancement: group 1 (5, 20, 45 s); group 2 (10, 25, 50s); and group 3 (15, 30, 55 s). Mean CT values (HU) of the abdominal aorta, renal artery, renal vein, renal cortex, and renal medulla were measured; increases in CT values pre- to post-contrast were assessed as contrast enhancement. Renal artery-to-vein and renal cortex-to-medulla contrast differences were also assessed. Qualitative analysis was also performed.
Mean renal artery enhancement was 240-288 HU at 5-15s after the trigger and peaked at 10s (P<.001). Mean renal cortical enhancement was 195-217 HU at 10-30s and peaked at 25s (P<.01). Contrast enhancement in the renal medulla increased gradually and reached mean 145 HU at 55 s. Cortex-to-medulla contrast difference was high (110-140 HU) at 5-30s and decreased below 30 HU at 45 s after the trigger. Renal artery-to-vein contrast difference was high (121-125 HU) at 5-10s. Qualitative results correlated well with quantitative results.
For the injection protocol used in this study, optimal scan delays after the bolus-tracking trigger were 5-10 s for renal arterial, 15-25 s for corticomedullary, and 50-55 s for nephrographic phases.
使用团注追踪技术，确定在肾脏的多排螺旋计算机断层扫描（MDCT）中，肾动脉期、皮质髓质期和肾实质期成像的最佳扫描延迟时间。
128例患者在以4mL/s的速度静脉注射2mL/kg的300mgI/mL造影剂后，接受了八排MDCT肾脏三期扫描。在主动脉造影剂增强至50HU触发团注追踪后，患者被前瞻性随机分为三组，三组扫描期（动脉期、皮质髓质期和肾实质期）的扫描延迟时间不同：第1组（5、20、45秒）；第2组（10、25、50秒）；第3组（15、30、55秒）。测量腹主动脉、肾动脉、肾静脉、肾皮质和肾髓质的平均CT值（HU）；评估造影剂注射前后CT值的增加作为造影剂增强情况。还评估了肾动脉与静脉以及肾皮质与髓质之间的造影剂差异。同时进行了定性分析。
触发后5 - 15秒时肾动脉平均增强为240 - 288HU，在10秒时达到峰值（P <.001）。10 - 30秒时肾皮质平均增强为195 - 217HU，在25秒时达到峰值（P <.01）。肾髓质的造影剂增强逐渐增加，在55秒时平均达到145HU。触发后5 - 30秒时皮质与髓质的造影剂差异较高（110 - 140HU），在45秒时降至30HU以下。5 - 10秒时肾动脉与静脉的造影剂差异较高（121 - 125HU）。定性结果与定量结果相关性良好。
对于本研究中使用的注射方案，团注追踪触发后的最佳扫描延迟时间为：肾动脉期5 - 10秒，皮质髓质期15 - 25秒，肾实质期50 - 55秒。
